1 CFR 51.9 - What is the proper language of incorporation?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false What is the proper language of incorporation... What is the proper language of incorporation? (a) The language incorporating a publication by reference... is intended and completed by the final rule document in which it appears. (b) The language...

TEMPTING system: a hybrid method of rule and machine learning for temporal relation extraction in patient discharge summaries.

PubMed

Chang, Yung-Chun; Dai, Hong-Jie; Wu, Johnny Chi-Yang; Chen, Jian-Ming; Tsai, Richard Tzong-Han; Hsu, Wen-Lian

2013-12-01

Patient discharge summaries provide detailed medical information about individuals who have been hospitalized. To make a precise and legitimate assessment of the abundant data, a proper time layout of the sequence of relevant events should be compiled and used to drive a patient-specific timeline, which could further assist medical personnel in making clinical decisions. The process of identifying the chronological order of entities is called temporal relation extraction. In this paper, we propose a hybrid method to identify appropriate temporal links between a pair of entities. The method combines two approaches: one is rule-based and the other is based on the maximum entropy model. We develop an integration algorithm to fuse the results of the two approaches. All rules and the integration algorithm are formally stated so that one can easily reproduce the system and results. To optimize the system's configuration, we used the 2012 i2b2 challenge TLINK track dataset and applied threefold cross validation to the training set. Then, we evaluated its performance on the training and test datasets. The experiment results show that the proposed TEMPTING (TEMPoral relaTion extractING) system (ranked seventh) achieved an F-score of 0.563, which was at least 30% better than that of the baseline system, which randomly selects TLINK candidates from all pairs and assigns the TLINK types. The TEMPTING system using the hybrid method also outperformed the stage-based TEMPTING system. Its F-scores were 3.51% and 0.97% better than those of the stage-based system on the training set and test set, respectively. Copyright © 2013 Elsevier Inc. All rights reserved.

Guidance for Halon Emissions Reduction Rule (40 CFR Part 82, Subpart H)

EPA Pesticide Factsheets

Document provides guidance for technicians on compliance with EPA's halon emission reduction rule (40 CFR 82, Subpart H). Guidance covers technician training requirements and proper halon disposal and recycling.

The Overtime Rule in the National Football League: Fair or Unfair?

ERIC Educational Resources Information Center

Gorgievski, Nicholas; DeFranco, Thomas C.; Swaminatha, Hariharan; Sofronas, Kimberly S.

2010-01-01

In 1974, the National Football League (NFL) initiated a sudden death overtime rule for games ending in a tie score at the end of regulation time. The rule states that the sudden death system of determining the winner shall prevail when the score is tied at the end of the regulation playing time of all NFL games. The team scoring first during…

Item hierarchy-based analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke.

PubMed

Roorda, Leo D; Green, John R; Houwink, Annemieke; Bagley, Pam J; Smith, Jane; Molenaar, Ivo W; Geurts, Alexander C

2012-06-01

To enable improved interpretation of the total score and faster scoring of the Rivermead Mobility Index (RMI) by studying item ordering or hierarchy and formulating start-and-stop rules in patients after stroke. Cohort study. Rehabilitation center in the Netherlands; stroke rehabilitation units and the community in the United Kingdom. Item hierarchy of the RMI was studied in an initial group of patients (n=620; mean age ± SD, 69.2±12.5y; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269 [43%] right hemisphere lesion), and the adequacy of the item hierarchy-based start-and-stop rules was checked in a second group of patients (n=237; mean age ± SD, 60.0±11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93 [39%] right hemisphere lesion) undergoing rehabilitation after stroke. Not applicable. Mokken scale analysis was used to investigate the fit of the double monotonicity model, indicating hierarchical item ordering. The percentages of patients with a difference between the RMI total score and the scores based on the start-and-stop rules were calculated to check the adequacy of these rules. The RMI had good fit of the double monotonicity model (coefficient H(T)=.87). The interpretation of the total score improved. Item hierarchy-based start-and-stop rules were formulated. The percentages of patients with a difference between the RMI total score and the score based on the recommended start-and-stop rules were 3% and 5%, respectively. Ten of the original 15 items had to be scored after applying the start-and-stop rules. Item hierarchy was established, enabling improved interpretation and faster scoring of the RMI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

42 CFR 35.1 - Hospital and station rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in charge of a station or hospital of the Service is authorized to adopt such rules and issue such instructions... for the efficient operation of the station or hospital and for the proper and humane care and...

Medicaid program; elimination of reimbursement under Medicaid for school administration expenditures and costs related to transportation of school-age children between home and school. Final rule.

PubMed

2007-12-28

Under the Medicaid program, Federal payment is available for the costs of administrative activities "as found necessary by the Secretary for the proper and efficient administration of the State plan." This final rule eliminates Federal Medicaid payment for the costs of certain school-based administrative and transportation activities because the Secretary has found that these activities are not necessary for the proper and efficient administration of the Medicaid State plan and are not within the definition of the optional transportation benefit. Based on these determinations, under this final rule, Federal Medicaid payments will no longer be available for administrative activities performed by school employees or contractors, or anyone under the control of a public or private educational institution, and for transportation from home to school. In addition, this final rule responds to public comments received on the September 7, 2007 proposed rule.

The modified Memorial Symptom Assessment Scale Short Form: a modified response format and rational scoring rules.

PubMed

Sharp, J L; Gough, K; Pascoe, M C; Drosdowsky, A; Chang, V T; Schofield, P

2018-07-01

The Memorial Symptom Assessment Scale Short Form (MSAS-SF) is a widely used symptom assessment instrument. Patients who self-complete the MSAS-SF have difficulty following the two-part response format, resulting in incorrectly completed responses. We describe modifications to the response format to improve useability, and rational scoring rules for incorrectly completed items. The modified MSAS-SF was completed by 311 women in our Peer and Nurse support Trial to Assist women in Gynaecological Oncology; the PeNTAGOn study. Descriptive statistics were used to summarise completion of the modified MSAS-SF, and provide symptom statistics before and after applying the rational scoring rules. Spearman's correlations with the Functional Assessment for Cancer Therapy-General (FACT-G) and Hospital Anxiety and Depression Scale (HADS) were assessed. Correct completion of the modified MSAS-SF items ranged from 91.5 to 98.7%. The rational scoring rules increased the percentage of useable responses on average 4% across all symptoms. MSAS-SF item statistics were similar with and without the scoring rules. The pattern of correlations with FACT-G and HADS was compatible with prior research. The modified MSAS-SF was useable for self-completion and responses demonstrated validity. The rational scoring rules can minimise loss of data from incorrectly completed responses. Further investigation is recommended.

Comparison of hypopnea definitions in lean patients with known obstructive sleep apnea hypopnea syndrome (OSAHS).

PubMed

Guilleminault, C; Hagen, C C; Huynh, N T

2009-11-01

In the interest of improving inter-rater reliability and standardization between sleep laboratories, hypopnea definitions were recently changed to place less emphasis on arousal scoring and more emphasis on oxygen desaturations. We sought to determine whether these changes would affect detection and treatment of OSAHS in lean patients-a group known to desaturate less-than-obese patients. Thirty-five lean subjects (15 male, 20 women, five post-menopausal) diagnosed OSAHS and a documented benefit from treatment had diagnostic polysomnograms (PSG) originally scored using the American Academy of Sleep Medicine (AASM) rule from 1999 (referred to as "Rule C"). These patients had appropriate clinical care based on those results. PSG records were then re-scored in a randomized and blinded fashion utilizing hypopnea Rule A and B of the 2007 AASM guidelines. Baseline mean (SD) apnea hypopnea indices (AHI) for rules A, B, and C were 6.4 (3.1), 20.6 (8.2), and 26.9 (7.3), respectively (p < 0.0001). Mean (SD) BMI was 24.4 (1.0). By design, all subjects were treatment responders. Eighty-six percent with CPAP, 83% with oral appliance, and 100% with surgical intervention reported resolution of their initial daytime or sleep complaint. Post-treatment AHIs for rules A, B, and C were 0.8 (0.9), 1.8 (1.2) and 2.3 (1.6; p < 0.001). In all three scoring conditions, the AHI was reduced significantly with treatment (p < 0.001). A repeated measures ANOVA of the difference between scoring methods indicated statistically significant differences between all three strategies at both pre- and post-treatment (p < 0.001). Sleepiness on the Epworth sleepiness scale decreased from a mean of 10.9 (2.3) to 5.7 (1.3) with treatment (p < 0.001). This change in subjective rating of sleepiness was more strongly correlated with rules B and C (r = 0.6) and more modestly correlated with Rule A scoring (r = 0.4). Response to treatment was more tightly correlated with arousal based scoring rules B and C in this group of lean subjects. The1999 hypopnea rule was used at baseline to detect this cohort of patients with OSAHS that ultimately benefitted from treatment. Rule B detected OSAHS and correlated well with response to treatment, but many more were categorized as mild (5 < AHI < 15) at baseline. Since 40% of the subjects had an AHI less than 5 with Rule A, lack of sensitivity should be considered before applying Rule A to the scoring of sleep studies in lean patients.

76 FR 13007 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

... of the Exchange's rules, particularly those parties who may not pay attention to mere warnings that... principal orders they represent as agent unless proper exposure parameters are applied. For these minor... ``Failure to satisfy the Order Exposure Requirements set forth in Rule 6.47A and its Commentary'' and Rule...

Reliability of the CARE rule and the HEART score to rule out an acute coronary syndrome in non-traumatic chest pain patients.

PubMed

Moumneh, Thomas; Richard-Jourjon, Vanessa; Friou, Emilie; Prunier, Fabrice; Soulie-Chavignon, Caroline; Choukroun, Jacques; Mazet-Guilaumé, Betty; Riou, Jérémie; Penaloza, Andréa; Roy, Pierre-Marie

2018-03-02

In patients consulting in the Emergency Department for chest pain, a HEART score ≤ 3 has been shown to rule out an acute coronary syndrome (ACS) with a low risk of major adverse cardiac event (MACE) occurrence. A negative CARE rule (≤ 1) that stands for the first four elements of the HEART score may have similar rule-out reliability without troponin assay requirement. We aim to prospectively assess the performance of the CARE rule and of the HEART score to predict MACE in a chest pain population. Prospective two-center non-interventional study. Patients admitted to the ED for non-traumatic chest pain were included, and followed-up at 6 weeks. The main study endpoint was the 6-week rate of MACE (myocardial infarction, coronary angioplasty, coronary bypass, and sudden unexplained death). 641 patients were included, of whom 9.5% presented a MACE at 6 weeks. The CARE rule was negative for 31.2% of patients, and none presented a MACE during follow-up [0, 95% confidence interval: (0.0-1.9)]. The HEART score was ≤ 3 for 63.0% of patients, and none presented a MACE during follow-up [0% (0.0-0.9)]. With an incidence below 2% in the negative group, the CARE rule seemed able to safely rule out a MACE without any biological test for one-third of patients with chest pain and the HEART score for another third with a single troponin assay.

Improving the accuracy of the diagnosis of schizophrenia by means of virtual reality.

PubMed

Sorkin, Anna; Weinshall, Daphna; Modai, Ilan; Peled, Avi

2006-03-01

The authors' goal was to improve the diagnosis of schizophrenia by using virtual reality technology to build a complex, multimodal environment in which cognitive functions can be studied (and measured) in parallel. The authors studied sensory integration within working memory by means of computer navigation through a virtual maze. The simulated journey consisted of a series of rooms, each of which included three doors. Each door was characterized by three features (color, shape, and sound), and a single combination of features--the door-opening rule--was correct. Subjects had to learn the rule and use it. The participants were 39 schizophrenic patients and 21 healthy comparison subjects. Upon completion, each subject was assigned a performance profile, including various error scores, response time, navigation ability, and strategy. A classification procedure based on the subjects' performance profile correctly predicted 85% of the schizophrenic patients (and all of the comparison subjects). Several performance variables showed significant correlations with scores on a standard diagnostic measure (Positive and Negative Syndrome Scale), suggesting potential use of these measurements for the diagnosis of schizophrenia. On the other hand, the patients did not show unusual repetition of response despite stimulus cessation (called "perseveration" in classical studies of schizophrenia), which is a common symptom of the disease. This deficit appeared only when the subjects did not receive proper explanation of the task. The ability to study multimodal performance simultaneously by using virtual reality technology opens new possibilities for the diagnosis of schizophrenia with objective procedures.

Comparative study of multimodal biometric recognition by fusion of iris and fingerprint.

PubMed

Benaliouche, Houda; Touahria, Mohamed

2014-01-01

This research investigates the comparative performance from three different approaches for multimodal recognition of combined iris and fingerprints: classical sum rule, weighted sum rule, and fuzzy logic method. The scores from the different biometric traits of iris and fingerprint are fused at the matching score and the decision levels. The scores combination approach is used after normalization of both scores using the min-max rule. Our experimental results suggest that the fuzzy logic method for the matching scores combinations at the decision level is the best followed by the classical weighted sum rule and the classical sum rule in order. The performance evaluation of each method is reported in terms of matching time, error rates, and accuracy after doing exhaustive tests on the public CASIA-Iris databases V1 and V2 and the FVC 2004 fingerprint database. Experimental results prior to fusion and after fusion are presented followed by their comparison with related works in the current literature. The fusion by fuzzy logic decision mimics the human reasoning in a soft and simple way and gives enhanced results.

Comparative Study of Multimodal Biometric Recognition by Fusion of Iris and Fingerprint

PubMed Central

Benaliouche, Houda; Touahria, Mohamed

2014-01-01

This research investigates the comparative performance from three different approaches for multimodal recognition of combined iris and fingerprints: classical sum rule, weighted sum rule, and fuzzy logic method. The scores from the different biometric traits of iris and fingerprint are fused at the matching score and the decision levels. The scores combination approach is used after normalization of both scores using the min-max rule. Our experimental results suggest that the fuzzy logic method for the matching scores combinations at the decision level is the best followed by the classical weighted sum rule and the classical sum rule in order. The performance evaluation of each method is reported in terms of matching time, error rates, and accuracy after doing exhaustive tests on the public CASIA-Iris databases V1 and V2 and the FVC 2004 fingerprint database. Experimental results prior to fusion and after fusion are presented followed by their comparison with related works in the current literature. The fusion by fuzzy logic decision mimics the human reasoning in a soft and simple way and gives enhanced results. PMID:24605065

Cardiorespiratory Fitness and Body Composition of Soccer Referees; Do These Correlate With Proper Performance?

PubMed

Mazaheri, Reza; Halabchi, Farzin; Seif Barghi, Tohid; Mansournia, Mohammad Ali

2016-03-01

The elite-level referee is exposed to similar physical demands to those placed on a midfield soccer player. They have an important responsibility to implement the rules of the game. So, good health and performance of soccer referees have a great importance. The purpose of this study was to assess the cardiorespiratory fitness and body composition of all 78 soccer referees officiating at the Iranian Premier League and determine the correlation between these parameters and performance. In a cross-sectional study, all referees selected for the competitions were enrolled. Participants underwent exercise stress test, pulmonary function test and body composition assessment. Then the weekly scores of each referee, assessed by qualified supervisors of national federation were obtained using the FIFA standard form throughout the season (34 weeks) and registered. Among 78 participants (including 32 center and 46 side referees), mean and standard deviation of age, body mass index, percent of body fat, VO2max and performance scores were 37 ± 3.8, 23.6 ± 2.1, 20.7 ± 3.9, 59.9 ± 7.1 and 85.8 ± 0.25, respectively. No significant correlation between referees' mean score and selected parameters were found. It seems that the acquired scores of top-class referees may be influenced by multiple factors other than the laboratory findings of cardiopulmonary fitness and body composition.

The SLE-key test serological signature: new insights into the course of lupus.

PubMed

Putterman, Chaim; Pisetsky, David S; Petri, Michelle; Caricchio, Roberto; Wu, Alan H B; Sanz, Ignacio; Oates, Jim C; Wallace, Steve; Sorek, Rachel; Gerwien, Robert; Safer, Pennina; Jakobi-Brook, Keren; Cohen, Irun R

2018-06-04

We previously described the multiplex autoantibody SLE-key Rule-Out test, which detects a signature of autoantibody reactivity that distinguishes healthy subjects from SLE patients with 94% sensitivity, 75% specificity and 93% negative predictive value; thus, an individual manifesting a positive Rule-Out test score is unlikely to have SLE (e.g. lupus is excluded). The objective of this current study was to evaluate the stability of the lupus-associated signature over time. We used banked serum samples from healthy subjects (n = 51) and lupus patients (n = 50 individual samples and n = 181 paired samples, for a total of n = 412 serum samples). The samples were drawn at different times after diagnosis to analyse the impact on the SLE-key Rule-Out test of time elapsed since diagnosis and any changes in disease activity (as reflected by the SLEDAI score). The SLE signature remains stable for the first 10 years after diagnosis; in this time frame, <10% of patients manifested a positive Rule-Out score and the SLE-key Rule-Out score was independent of the underlying disease activity as reflected by the SLEDAI score. After ⩾10 years, ∼30% of lupus subjects scored as SLE Ruled-Out; the proportion of patients manifesting this status was even greater in the subset of individuals with a SLEDAI score of 0. These findings raise the possibility that a significant number of SLE patients manifest a change in their serological signature over time, and that such a signature change may signify an evolution in the immunological features of their disease relevant to patient management.

Report: Policies Needed for Proper Use and Management of Cost-Reimbursement Contracts Based on Duncan Hunter Act

EPA Pesticide Factsheets

Report #12-P-0320, March 6, 2012. EPA did not comply with several key revisions to the FAR as amended by the interim rule, Proper Use and Management of Cost Reimbursement Contracts (FAR Case 2008-030).

Occupational exposure decisions: can limited data interpretation training help improve accuracy?

PubMed

Logan, Perry; Ramachandran, Gurumurthy; Mulhausen, John; Hewett, Paul

2009-06-01

Accurate exposure assessments are critical for ensuring that potentially hazardous exposures are properly identified and controlled. The availability and accuracy of exposure assessments can determine whether resources are appropriately allocated to engineering and administrative controls, medical surveillance, personal protective equipment and other programs designed to protect workers. A desktop study was performed using videos, task information and sampling data to evaluate the accuracy and potential bias of participants' exposure judgments. Desktop exposure judgments were obtained from occupational hygienists for material handling jobs with small air sampling data sets (0-8 samples) and without the aid of computers. In addition, data interpretation tests (DITs) were administered to participants where they were asked to estimate the 95th percentile of an underlying log-normal exposure distribution from small data sets. Participants were presented with an exposure data interpretation or rule of thumb training which included a simple set of rules for estimating 95th percentiles for small data sets from a log-normal population. DIT was given to each participant before and after the rule of thumb training. Results of each DIT and qualitative and quantitative exposure judgments were compared with a reference judgment obtained through a Bayesian probabilistic analysis of the sampling data to investigate overall judgment accuracy and bias. There were a total of 4386 participant-task-chemical judgments for all data collections: 552 qualitative judgments made without sampling data and 3834 quantitative judgments with sampling data. The DITs and quantitative judgments were significantly better than random chance and much improved by the rule of thumb training. In addition, the rule of thumb training reduced the amount of bias in the DITs and quantitative judgments. The mean DIT % correct scores increased from 47 to 64% after the rule of thumb training (P < 0.001). The accuracy for quantitative desktop judgments increased from 43 to 63% correct after the rule of thumb training (P < 0.001). The rule of thumb training did not significantly impact accuracy for qualitative desktop judgments. The finding that even some simple statistical rules of thumb improve judgment accuracy significantly suggests that hygienists need to routinely use statistical tools while making exposure judgments using monitoring data.

32 CFR 770.4 - Hunting regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Hunting regulations. 770.4 Section 770.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES RULES..., Virginia § 770.4 Hunting regulations. All persons possessing the proper State, Federal and Base licenses...

32 CFR 770.4 - Hunting regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Hunting regulations. 770.4 Section 770.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES RULES..., Virginia § 770.4 Hunting regulations. All persons possessing the proper State, Federal and Base licenses...

26 CFR 1.1016-2 - Items properly chargeable to capital account.

Code of Federal Regulations, 2010 CFR

2010-04-01

....1016-2 Section 1.1016-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Basis Rules of General Application § 1.1016-2 Items properly... for $10,000. He subsequently expended $6,000 for improvements. Disregarding, for the purpose of this...

Behavior Modification Revisited: Practical Application for the Reading Teacher.

ERIC Educational Resources Information Center

Lang, Deborah Odom; Lang, William Steve

An informal study examined the impact of a simple behavior modification procedure on the reading habits of second and fifth grade students. Behavior modification theory was pared down to two rules ("reinforce proper behavior" and "reinforce anything close to proper behavior") so that no additional burdens would be placed on…

32 CFR 1901.32 - Requests for expedited processing.

Code of Federal Regulations, 2010 CFR

2010-07-01

...-in, first-out” basis. Exceptions to this rule will only be made in circumstances that the Agency... health, humanitarian, or due process considerations involving possible deprivation of life or liberty... judicial precedent, requests more properly the scope of requests under the Federal Rules of Civil or...

A comparison of scoring weights for the EuroQol derived from patients and the general public.

PubMed

Polsky, D; Willke, R J; Scott, K; Schulman, K A; Glick, H A

2001-01-01

General health state classification systems, such as the EuroQol instrument, have been developed to improve the systematic measurement and comparability of health state preferences. In this paper we generate valuations for EuroQol health states using responses to this instrument's visual analogue scale made by patients enrolled in a randomized clinical trial evaluating tirilazad mesylate, a new drug used to treat subarachnoid haemorrhage. We then compare these valuations derived from patients with published valuations derived from responses made by a sample from the general public. The data were derived from two sources: (1) responses to the EuroQol instrument from 649 patients 3 months after enrollment in the clinical trial, and (2) from a published study reporting a scoring rule for the EuroQol instrument that was based upon responses made by the general public. We used a linear regression model to develop an additive scoring rule. This rule enables direct valuation of all 243 EuroQol health states using patients' scores for their own health states elicited using a visual analogue scale. We then compared predicted scores generated using our scoring rule with predicted scores derived from a sample from the general public. The predicted scores derived using the additive scoring rules met convergent validity criteria and explained a substantial amount of the variation in visual analogue scale scores (R(2)=0.57). In the pairwise comparison of the predicted scores derived from the study sample with those derived from the general public, we found that the former set of scores were higher for 223 of the 243 states. Despite the low level of correspondence in the pairwise comparison, the overall correlation between the two sets of scores was 87%. The model presented in this paper demonstrated that scoring weights for the EuroQol instrument can be derived directly from patient responses from a clinical trial and that these weights can explain a substantial amount of variation in health valuations. Scoring weights based on patient responses are significantly higher than those derived from the general public. Further research is required to understand the source of these differences. Copyright 2001 John Wiley & Sons, Ltd.

Healthcare provider perceptions of clinical prediction rules

PubMed Central

Richardson, Safiya; Khan, Sundas; McCullagh, Lauren; Kline, Myriam; Mann, Devin; McGinn, Thomas

2015-01-01

Objectives To examine internal medicine and emergency medicine healthcare provider perceptions of usefulness of specific clinical prediction rules. Setting The study took place in two academic medical centres. A web-based survey was distributed and completed by participants between 1 January and 31 May 2013. Participants Medical doctors, doctors of osteopathy or nurse practitioners employed in the internal medicine or emergency medicine departments at either institution. Primary and secondary outcome measures The primary outcome was to identify the clinical prediction rules perceived as most useful by healthcare providers specialising in internal medicine and emergency medicine. Secondary outcomes included comparing usefulness scores of specific clinical prediction rules based on provider specialty, and evaluating associations between usefulness scores and perceived characteristics of these clinical prediction rules. Results Of the 401 healthcare providers asked to participate, a total of 263 (66%), completed the survey. The CHADS2 score was chosen by most internal medicine providers (72%), and Pulmonary Embolism Rule-Out Criteria (PERC) score by most emergency medicine providers (45%), as one of the top three most useful from a list of 24 clinical prediction rules. Emergency medicine providers rated their top three significantly more positively, compared with internal medicine providers, as having a better fit into their workflow (p=0.004), helping more with decision-making (p=0.037), better fitting into their thought process when diagnosing patients (p=0.001) and overall, on a 10-point scale, more useful (p=0.009). For all providers, the perceived qualities of useful at point of care, helps with decision making, saves time diagnosing, fits into thought process, and should be the standard of clinical care correlated highly (≥0.65) with overall 10-point usefulness scores. Conclusions Healthcare providers describe clear preferences for certain clinical prediction rules, based on medical specialty. PMID:26338684

Rule Space, the Product Space of Two Score Components in Signed-Number Subtraction: An Approach to Dealing with Inconsistent Use of Erroneous Rules.

ERIC Educational Resources Information Center

Tatsuoka, Kikumi K.; Baillie, Robert

A 40-item free response test on signed-number subtraction was administered to 172 eighth graders. Their responses are viewed as consisting of two different components, the sign and absolute value. Each component is scored zero for wrong or one for correct, yielding a score of one only when both components have scores of one. By taking the values…

18 CFR 385.2006 - Docket system (Rule 2006).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Docket system (Rule 2006). 385.2006 Section 385.2006 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... availability is consistent with the proper discharge of the Commission's duties and in conformity with part 388...

78 FR 79714 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... arrangements. Approximately 300 companies annually rely on the Rule 701 exemption. The Rule 701 disclosure... that 25% of the 2 hours per response (0.5 hours) is prepared by the company for a total annual...) Whether the proposed collection of information is necessary for the proper performance of the functions of...

32 CFR 1801.32 - Requests for expedited processing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... “first-in, first-out” basis. Exceptions to this rule will only be made in circumstances that NACIC deems... health, humanitarian, or due process considerations involving possible deprivation of life or liberty... judicial precedent, requests more properly the scope of requests under the Federal Rules of Civil or...

77 FR 55371 - System Safety Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

...-based rule and FRA seeks comments on all aspects of the proposed rule. An SSP would be implemented by a... SSP would be the risk-based hazard management program and risk-based hazard analysis. A properly implemented risk-based hazard management program and risk-based hazard analysis would identify the hazards and...

14 CFR 105.19 - Parachute operations between sunset and sunrise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES PARACHUTE OPERATIONS Operating Rules § 105.19... between sunset and sunrise, unless the person or object descending from the aircraft displays a light that... be displayed from the time that the person or object is under a properly functioning open parachute...

Stressed out and overcommitted! The relationships between time demands and family rules and parents’ and their child’s weight status

PubMed Central

Hearst, Mary O.; Sevcik, Sarah; Fulkerson, Jayne A.; Pasch, Keryn E.; Harnack, Lisa J.; Lytle, Leslie A.

2013-01-01

Objective To determine the relationship between parent time demands and presence and enforcement of family rules and parent/child dyad weight status. Methods Dyads of one child/parent per family (n=681dyads), Twin Cities, Minnesota, 2007–2008 had measured height/weight and a survey of demographics, time demands and family rules-related questions. Parent/child dyads were classified into four healthy weight/overweight categories. Multivariate linear associations were analyzed with SAS, testing for interaction by work status and family composition (p<0.10). Results In adjusted models, lack of family rules and difficulty with rule enforcement were statistically lower in dyads in which the parent/child was healthy weight compared to dyads in which the parent/child was both overweight (Difference in family rules scores=0.49, p=0.03; difference in rule enforcement scores=1.09, p=<0.01). Of parents who worked full-time, healthy weight dyads reported lower time demands than other dyads (Difference in time demands scores=1.44, p=0.01). Conclusions Family experiences of time demands and use of family rules are related to the weight status of parents and children within families. PMID:22228775

NHEXAS PHASE I REGION 5 STUDY--STANDARD OPERATING PROCEDURE FOR PROPER USE AND MAINTENANCE OF LABORATORY NOTEBOOKS (NHX/SOP-120-001)

EPA Science Inventory

This procedure describes in detail the rules and regulations governing the proper use and maintenance of laboratory notebooks. The purpose of laboratory notebooks was to provide a permanent legal record of experimental procedures and results. Thus, the laboratory notebook served ...

49 CFR 171.14 - Transitional provisions for implementing certain requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Table in effect on September 30, 2001. (5) Proper shipping names that included the word “inhibited... shipping papers in place of the word “stabilized” until October 1, 2007. Proper shipping names that included the word “compressed” prior to the final rule published on July 31, 2003 and effective on October...

26 CFR 1.851-3 - Rules applicable to section 851(b)(4).

Code of Federal Regulations, 2010 CFR

2010-04-01

... TAX (CONTINUED) INCOME TAXES Regulated Investment Companies and Real Estate Investment Trusts § 1.851-3 Rules applicable to section 851(b)(4). In determining the value of the taxpayer's investment in... shall be included its proper proportion of the investment of any other corporation, a member of a...

Evaluating California Campus Tobacco Policies Using the American College Health Association Guidelines and the Institutional Grammar Tool

PubMed Central

Roditis, Maria L; Wang, Donna; Glantz, Stanton; Fallin, Amanda

2014-01-01

Objective Measure comprehensiveness of California campus tobacco policies. Participants 16 campuses representing different regions, institution types, and policies. Research occurred June-August, 2013. Methods Comprehensiveness was scored using American College Health Association's (ACHA) Position Statement on Tobacco. The Institutional Grammar Tool was used to breakdown policy statements into Strategies, Norms, or Rules. Differences in ACHA score and number of Strategies, Norms, and Rules were assessed by region, policy, and institution type. Results Median ACHA score was 0.35 (scale of 0–1). Schools with 100% tobacco-free policies had highest ACHA scores, but failed to address relationships between schools and tobacco companies. Less than half the schools assessed (7/16) had Rules (enforceable penalties related to policies). In 67% of the policy statements, individuals doing the action were implied (not specifically stated). Conclusion Campuses should address ACHA recommendations related to campus relationships with tobacco companies, include enforceable rules, and specify individuals and entities covered by policy. PMID:25257333

Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data meta-analysis.

PubMed

Geersing, G J; Zuithoff, N P A; Kearon, C; Anderson, D R; Ten Cate-Hoek, A J; Elf, J L; Bates, S M; Hoes, A W; Kraaijenhagen, R A; Oudega, R; Schutgens, R E G; Stevens, S M; Woller, S C; Wells, P S; Moons, K G M

2014-03-10

To assess the accuracy of the Wells rule for excluding deep vein thrombosis and whether this accuracy applies to different subgroups of patients. Meta-analysis of individual patient data. Authors of 13 studies (n = 10,002) provided their datasets, and these individual patient data were merged into one dataset. Studies were eligible if they enrolled consecutive outpatients with suspected deep vein thrombosis, scored all variables of the Wells rule, and performed an appropriate reference standard. Multilevel logistic regression models, including an interaction term for each subgroup, were used to estimate differences in predicted probabilities of deep vein thrombosis by the Wells rule. In addition, D-dimer testing was added to assess differences in the ability to exclude deep vein thrombosis using an unlikely score on the Wells rule combined with a negative D-dimer test result. Overall, increasing scores on the Wells rule were associated with an increasing probability of having deep vein thrombosis. Estimated probabilities were almost twofold higher in patients with cancer, in patients with suspected recurrent events, and (to a lesser extent) in males. An unlikely score on the Wells rule (≤ 1) combined with a negative D-dimer test result was associated with an extremely low probability of deep vein thrombosis (1.2%, 95% confidence interval 0.7% to 1.8%). This combination occurred in 29% (95% confidence interval 20% to 40%) of patients. These findings were consistent in subgroups defined by type of D-dimer assay (quantitative or qualitative), sex, and care setting (primary or hospital care). For patients with cancer, the combination of an unlikely score on the Wells rule and a negative D-dimer test result occurred in only 9% of patients and was associated with a 2.2% probability of deep vein thrombosis being present. In patients with suspected recurrent events, only the modified Wells rule (adding one point for the previous event) is safe. Combined with a negative D-dimer test result (both quantitative and qualitative), deep vein thrombosis can be excluded in patients with an unlikely score on the Wells rule. This finding is true for both sexes, as well as for patients presenting in primary and hospital care. In patients with cancer, the combination is neither safe nor efficient. For patients with suspected recurrent disease, one extra point should be added to the rule to enable a safe exclusion.

Equations for Scoring Rules When Data Are Missing

NASA Technical Reports Server (NTRS)

James, Mark

2006-01-01

A document presents equations for scoring rules in a diagnostic and/or prognostic artificial-intelligence software system of the rule-based inference-engine type. The equations define a set of metrics that characterize the evaluation of a rule when data required for the antecedence clause(s) of the rule are missing. The metrics include a primary measure denoted the rule completeness metric (RCM) plus a number of subsidiary measures that contribute to the RCM. The RCM is derived from an analysis of a rule with respect to its truth and a measure of the completeness of its input data. The derivation is such that the truth value of an antecedent is independent of the measure of its completeness. The RCM can be used to compare the degree of completeness of two or more rules with respect to a given set of data. Hence, the RCM can be used as a guide to choosing among rules during the rule-selection phase of operation of the artificial-intelligence system..

75 FR 4463 - Race to the Top Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

..., requirements, definitions, and selection criteria; correction. SUMMARY: On November 18, 2009, the Department of... the November 18 Final Rule was the Scoring Rubric that the Department developed for the scoring of... to the November 18 Final Rule. DATES: Effective Date: January 27, 2010. FOR FURTHER INFORMATION...

Negation handling in sentiment classification using rule-based adapted from Indonesian language syntactic for Indonesian text in Twitter

NASA Astrophysics Data System (ADS)

Amalia, Rizkiana; Arif Bijaksana, Moch; Darmantoro, Dhinta

2018-03-01

The presence of the word negation is able to change the polarity of the text if it is not handled properly it will affect the performance of the sentiment classification. Negation words in Indonesian are ‘tidak’, ‘bukan’, ‘belum’ and ‘jangan’. Also, there is a conjunction word that able to reverse the actual values, as the word ‘tetapi’, or ‘tapi’. Unigram has shortcomings in dealing with the existence of negation because it treats negation word and the negated words as separate words. A general approach for negation handling in English text gives the tag ‘NEG_’ for following words after negation until the first punctuation. But this may gives the tag to un-negated, and this approach does not handle negation and conjunction in one sentences. The rule-based method to determine what words negated by adapting the rules of Indonesian language syntactic of negation to determine the scope of negation was proposed in this study. With adapting syntactic rules and tagging “NEG_” using SVM classifier with RBF kernel has better performance results than the other experiments. Considering the average F1-score value, the performance of this proposed method can be improved against baseline equal to 1.79% (baseline without negation handling) and 5% (baseline with existing negation handling) for a dataset that all tweets contain negation words. And also for the second dataset that has the various number of negation words in document tweet. It can be improved against baseline at 2.69% (without negation handling) and 3.17% (with existing negation handling).

Alternative Treatment in Prostate Pain Syndrome Based on Iranian Traditional Medicine

PubMed Central

Latifi, Seied Amirhossein; Kamalinejad, Mohammad; Minaiee, Bagher; Bahrami, Mohsen; Gooran, Shahram; Nikbakht Nasrabadi, Alireza

2014-01-01

Introduction: Unknown etiology and pathophysiology of prostate pain syndrome (PPS) has led to a lack of proper and competent treatment in modern medicine. According to the guidelines of European Association of Urology (EAU), use of complementary treatments is recommended for PPS. In this preliminary study, analyzing the signs and symptoms of PPS from the viewpoint of Iranian traditional medicine (ITM) was helpful in selecting the appropriate alternative treatment. Case Presentation: Two male patients diagnosed with PPS were evaluated and treated according to the ITM. Each patient took 15 mL oxymel 45 minutes after lunch and dinner. For each patient, four clinical visits were made with one week intervals and the validated Farsi version of international prostate symptom score (IPSS) and numeric pain rating score (NPRS) were completed for them. Conclusions: Considering the fact that other major pathological causes are ruled out, many of the symptoms and signs observed in these patients were similar to those associated with flatulency-related diseases in ITM. Selecting treatment with oxymel was based on this view and led to improvements in the digestive and urinary symptoms according to Farsi version of the IPSS and NPRS. PMID:25237573

12 CFR 269b.710 - Rules to be liberally construed.

Code of Federal Regulations, 2010 CFR

2010-01-01

... compliance with the terms of the rules and regulations in this subchapter will work an injustice or... and to effectuate the purposes of the policy. (b) When an act is required or allowed to be done at or... shall be manifest that strict adherence will work surprise or injustice or interfere with the proper...

26 CFR 1.42-13 - Rules necessary and appropriate; housing credit agencies' correction of administrative errors and...

Code of Federal Regulations, 2010 CFR

2010-04-01

... this paragraph (b)(2) include the following— (i) A mathematical error; (ii) An entry on a document that... errors or omissions that occurred before the publication of these regulations. Any reasonable method used... February 24, 1994, will be considered proper, provided that the method is consistent with the rules of...

36 CFR 1254.42 - What are the rules that apply to using self-service microfilm?

Code of Federal Regulations, 2011 CFR

2011-07-01

... finished, remove it from the reader, and return it to the proper microfilm box. You must carefully remove from and return to the proper microfilm boxes rewound microfilm. You must take care when loading and... you discover it. (c) Unless we make an exception, you may use only one roll of microfilm at a time. (d...

36 CFR 1254.42 - What are the rules that apply to using self-service microfilm?

Code of Federal Regulations, 2010 CFR

2010-07-01

... finished, remove it from the reader, and return it to the proper microfilm box. You must carefully remove from and return to the proper microfilm boxes rewound microfilm. You must take care when loading and... you discover it. (c) Unless we make an exception, you may use only one roll of microfilm at a time. (d...

36 CFR 1254.42 - What are the rules that apply to using self-service microfilm?

Code of Federal Regulations, 2012 CFR

2012-07-01

... finished, remove it from the reader, and return it to the proper microfilm box. You must carefully remove from and return to the proper microfilm boxes rewound microfilm. You must take care when loading and... you discover it. (c) Unless we make an exception, you may use only one roll of microfilm at a time. (d...

36 CFR 1254.42 - What are the rules that apply to using self-service microfilm?

Code of Federal Regulations, 2014 CFR

2014-07-01

... finished, remove it from the reader, and return it to the proper microfilm box. You must carefully remove from and return to the proper microfilm boxes rewound microfilm. You must take care when loading and... you discover it. (c) Unless we make an exception, you may use only one roll of microfilm at a time. (d...

Searching for discrimination rules in protease proteolytic cleavage activity using genetic programming with a min-max scoring function.

PubMed

Yang, Zheng Rong; Thomson, Rebecca; Hodgman, T Charles; Dry, Jonathan; Doyle, Austin K; Narayanan, Ajit; Wu, XiKun

2003-11-01

This paper presents an algorithm which is able to extract discriminant rules from oligopeptides for protease proteolytic cleavage activity prediction. The algorithm is developed using genetic programming. Three important components in the algorithm are a min-max scoring function, the reverse Polish notation (RPN) and the use of minimum description length. The min-max scoring function is developed using amino acid similarity matrices for measuring the similarity between an oligopeptide and a rule, which is a complex algebraic equation of amino acids rather than a simple pattern sequence. The Fisher ratio is then calculated on the scoring values using the class label associated with the oligopeptides. The discriminant ability of each rule can therefore be evaluated. The use of RPN makes the evolutionary operations simpler and therefore reduces the computational cost. To prevent overfitting, the concept of minimum description length is used to penalize over-complicated rules. A fitness function is therefore composed of the Fisher ratio and the use of minimum description length for an efficient evolutionary process. In the application to four protease datasets (Trypsin, Factor Xa, Hepatitis C Virus and HIV protease cleavage site prediction), our algorithm is superior to C5, a conventional method for deriving decision trees.

Mining HIV protease cleavage data using genetic programming with a sum-product function.

PubMed

Yang, Zheng Rong; Dalby, Andrew R; Qiu, Jing

2004-12-12

In order to design effective HIV inhibitors, studying and understanding the mechanism of HIV protease cleavage specification is critical. Various methods have been developed to explore the specificity of HIV protease cleavage activity. However, success in both extracting discriminant rules and maintaining high prediction accuracy is still challenging. The earlier study had employed genetic programming with a min-max scoring function to extract discriminant rules with success. However, the decision will finally be degenerated to one residue making further improvement of the prediction accuracy difficult. The challenge of revising the min-max scoring function so as to improve the prediction accuracy motivated this study. This paper has designed a new scoring function called a sum-product function for extracting HIV protease cleavage discriminant rules using genetic programming methods. The experiments show that the new scoring function is superior to the min-max scoring function. The software package can be obtained by request to Dr Zheng Rong Yang.

Pooled individual patient data from five countries were used to derive a clinical prediction rule for coronary artery disease in primary care.

PubMed

Aerts, Marc; Minalu, Girma; Bösner, Stefan; Buntinx, Frank; Burnand, Bernard; Haasenritter, Jörg; Herzig, Lilli; Knottnerus, J André; Nilsson, Staffan; Renier, Walter; Sox, Carol; Sox, Harold; Donner-Banzhoff, Norbert

2017-01-01

To construct a clinical prediction rule for coronary artery disease (CAD) presenting with chest pain in primary care. Meta-Analysis using 3,099 patients from five studies. To identify candidate predictors, we used random forest trees, multiple imputation of missing values, and logistic regression within individual studies. To generate a prediction rule on the pooled data, we applied a regression model that took account of the differing standard data sets collected by the five studies. The most parsimonious rule included six equally weighted predictors: age ≥55 (males) or ≥65 (females) (+1); attending physician suspected a serious diagnosis (+1); history of CAD (+1); pain brought on by exertion (+1); pain feels like "pressure" (+1); pain reproducible by palpation (-1). CAD was considered absent if the prediction score is <2. The area under the ROC curve was 0.84. We applied this rule to a study setting with a CAD prevalence of 13.2% using a prediction score cutoff of <2 (i.e., -1, 0, or +1). When the score was <2, the probability of CAD was 2.1% (95% CI: 1.1-3.9%); when the score was ≥ 2, it was 43.0% (95% CI: 35.8-50.4%). Clinical prediction rules are a key strategy for individualizing care. Large data sets based on electronic health records from diverse sites create opportunities for improving their internal and external validity. Our patient-level meta-analysis from five primary care sites should improve external validity. Our strategy for addressing site-to-site systematic variation in missing data should improve internal validity. Using principles derived from decision theory, we also discuss the problem of setting the cutoff prediction score for taking action. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 144.84 - Do I need to get a permit?

Code of Federal Regulations, 2010 CFR

2010-07-01

... V injection activity is “authorized by rule,” meaning you have to comply with all the requirements... Class V well is no longer authorized by rule. This means that you have to either get a permit or close... authorization expires once you have properly closed your well, as described in § 144.82(b). (b) Circumstances in...

Implications of revised AASM rules on scoring apneic and hypopneic respiratory events in patients with heart failure with nocturnal Cheyne-Stokes respiration.

PubMed

Heinrich, Jessica; Spießhöfer, Jens; Bitter, Thomas; Horstkotte, Dieter; Oldenburg, Olaf

2015-05-01

This study investigated the implications of the revised scoring rules of the American Academy of Sleep Medicine (AASM) in patients with heart failure (HF) with Cheyne-Stokes respiration (CSR). Ninety-one patients (NYHA ≥II, LVEF ≤45 %; age 73.6 ± 11.3 years old; 81 male subjects) with documented CSR underwent 8 h of cardiorespiratory polygraphy recordings. Those were analyzed by a single scorer strictly applying the 2007 recommended, 2007 alternative, and the 2012 scoring rules. Compared with the AASM 2007 recommended rules, apnea-hypopnea index (AHI) and hypopnea index (HI) increased significantly when the 2007 alternative and 2012 rules were applied (AHI 34.1 ± 13.5/h vs 37.6 ± 13.2/h vs 38.3 ± 13.2/h, respectively; HI 10.2 ± 9.4/h vs 13.7 ± 10.7/h vs 14.4 ± 11.0/h, respectively; all p < 0.001). Duration of CSR increased significantly with the alternate versus recommended 2007 rules (182.2 ± 117.0 vs 170.1 ± 115.0 min; p ≤ 0.001); there was a significant decrease in CSR duration for the 2012 versus 2007 alternative rules (182.2 ± 117.0 vs 166.7 ± 115.4 min; p ≤ 0.001). AHI was higher using the AASM 2012 scoring rules due to a less strict definition of hypopnea. Data on the prognostic effects of CSR in patients with HF and the benefits of treatment are mostly based on the AASM 2007 recommended rules, so differences between these and the newer version need to be taken into account.

ConGEMs: Condensed Gene Co-Expression Module Discovery Through Rule-Based Clustering and Its Application to Carcinogenesis.

PubMed

Mallik, Saurav; Zhao, Zhongming

2017-12-28

For transcriptomic analysis, there are numerous microarray-based genomic data, especially those generated for cancer research. The typical analysis measures the difference between a cancer sample-group and a matched control group for each transcript or gene. Association rule mining is used to discover interesting item sets through rule-based methodology. Thus, it has advantages to find causal effect relationships between the transcripts. In this work, we introduce two new rule-based similarity measures-weighted rank-based Jaccard and Cosine measures-and then propose a novel computational framework to detect condensed gene co-expression modules ( C o n G E M s) through the association rule-based learning system and the weighted similarity scores. In practice, the list of evolved condensed markers that consists of both singular and complex markers in nature depends on the corresponding condensed gene sets in either antecedent or consequent of the rules of the resultant modules. In our evaluation, these markers could be supported by literature evidence, KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway and Gene Ontology annotations. Specifically, we preliminarily identified differentially expressed genes using an empirical Bayes test. A recently developed algorithm-RANWAR-was then utilized to determine the association rules from these genes. Based on that, we computed the integrated similarity scores of these rule-based similarity measures between each rule-pair, and the resultant scores were used for clustering to identify the co-expressed rule-modules. We applied our method to a gene expression dataset for lung squamous cell carcinoma and a genome methylation dataset for uterine cervical carcinogenesis. Our proposed module discovery method produced better results than the traditional gene-module discovery measures. In summary, our proposed rule-based method is useful for exploring biomarker modules from transcriptomic data.

36 CFR § 1254.42 - What are the rules that apply to using self-service microfilm?

Code of Federal Regulations, 2013 CFR

2013-07-01

... finished, remove it from the reader, and return it to the proper microfilm box. You must carefully remove from and return to the proper microfilm boxes rewound microfilm. You must take care when loading and... you discover it. (c) Unless we make an exception, you may use only one roll of microfilm at a time. (d...

The Effect of Rules and Discovery in the Retention and Retrieval of Braille Inkprint Letter Pairs.

ERIC Educational Resources Information Center

Nagengast, Daniel L.; And Others

The effects of rule knowledge were investigated using Braille inkprint pairs. Both recognition and recall were studied in three groups of subjects: rule knowledge, rule discovery, and no rule. Two hypotheses were tested: (1) that the group exposed to the rule would score better than would a discovery group and a control group; and (2) that all…

Updated Procedures for Determining Gifted Eligibility for Underrepresented Students. Research Note. RN1201

ERIC Educational Resources Information Center

Froman, Terry

2012-01-01

There are a number of detailed requirements for gifted screening, referral and eligibility specified under State Board Rules and School Board Rules. In all of these areas, explicit mention is made of the Florida Comprehensive Assessment Test (FCAT) scores as being integral components. The FCAT scores used for these purposes prior to 2008 were…

Post-decomposition optimizations using pattern matching and rule-based clustering for multi-patterning technology

NASA Astrophysics Data System (ADS)

Wang, Lynn T.-N.; Madhavan, Sriram

2018-03-01

A pattern matching and rule-based polygon clustering methodology with DFM scoring is proposed to detect decomposition-induced manufacturability detractors and fix the layout designs prior to manufacturing. A pattern matcher scans the layout for pre-characterized patterns from a library. If a pattern were detected, rule-based clustering identifies the neighboring polygons that interact with those captured by the pattern. Then, DFM scores are computed for the possible layout fixes: the fix with the best score is applied. The proposed methodology was applied to two 20nm products with a chip area of 11 mm2 on the metal 2 layer. All the hotspots were resolved. The number of DFM spacing violations decreased by 7-15%.

A Consistent Set of Oxidation Number Rules for Intelligent Computer Tutoring

NASA Astrophysics Data System (ADS)

Holder, Dale A.; Johnson, Benny G.; Karol, Paul J.

2002-04-01

We have developed a method for assigning oxidation numbers that eliminates the inconsistencies and ambiguities found in most conventional textbook rules, yet remains simple enough for beginning students to use. It involves imposition of a two-level hierarchy on a set of rules similar to those already being taught. We recommend emphasizing that the oxidation number method is an approximate model and cannot always be successfully applied. This proper perspective will lead students to apply the rules more carefully in all problems. Whenever failure does occur, it will indicate the limitations of the oxidation number concept itself, rather than merely the failure of a poorly constructed set of rules. We have used these improved rules as the basis for an intelligent tutoring program on oxidation numbers.

Grooming a CAT: customizing CAT administration rules to increase response efficiency in specific research and clinical settings.

PubMed

Kallen, Michael A; Cook, Karon F; Amtmann, Dagmar; Knowlton, Elizabeth; Gershon, Richard C

2018-05-05

To evaluate the degree to which applying alternative stopping rules would reduce response burden while maintaining score precision in the context of computer adaptive testing (CAT). Analyses were conducted on secondary data comprised of CATs administered in a clinical setting at multiple time points (baseline and up to two follow ups) to 417 study participants who had back pain (51.3%) and/or depression (47.0%). Participant mean age was 51.3 years (SD = 17.2) and ranged from 18 to 86. Participants tended to be white (84.7%), relatively well educated (77% with at least some college), female (63.9%), and married or living in a committed relationship (57.4%). The unit of analysis was individual assessment histories (i.e., CAT item response histories) from the parent study. Data were first aggregated across all individuals, domains, and time points in an omnibus dataset of assessment histories and then were disaggregated by measure for domain-specific analyses. Finally, assessment histories within a "clinically relevant range" (score ≥ 1 SD from the mean in direction of poorer health) were analyzed separately to explore score level-specific findings. Two different sets of CAT administration rules were compared. The original CAT (CAT ORIG ) rules required at least four and no more than 12 items be administered. If the score standard error (SE) reached a value < 3 points (T score metric) before 12 items were administered, the CAT was stopped. We simulated applying alternative stopping rules (CAT ALT ), removing the requirement that a minimum four items be administered, and stopped a CAT if responses to the first two items were both associated with best health, if the SE was < 3, if SE change < 0.1 (T score metric), or if 12 items were administered. We then compared score fidelity and response burden, defined as number of items administered, between CAT ORIG and CAT ALT . CAT ORIG and CAT ALT scores varied little, especially within the clinically relevant range, and response burden was substantially lower under CAT ALT (e.g., 41.2% savings in omnibus dataset). Alternate stopping rules result in substantial reductions in response burden with minimal sacrifice in score precision.

The AASM scoring manual: a critical appraisal.

PubMed

Grigg-Damberger, Madeleine M

2009-11-01

Summarize recently published studies and critiques evaluating the effects of the American Academy of Sleep Medicine (AASM) Sleep Scoring Manual. Only a few retrospective studies have been published evaluating the new AASM Scoring Manual. These have shown that when scoring polysomnograms (PSGs) using the AASM rules compared to previous standards and guidelines: increased amount and percentage of sleep time in Non-Rapid Eye Movement Sleep (NREM) 1 (N1) and N3 sleep, and decreased NREM 2 (N2) sleep; improved interscorer reliability when scoring sleep stages in adults; large differences in apnea-hypopnea indexes (AHIs) using different hypopnea scoring definitions; and PSGs scored using the 'recommended' hypopnea definition in the new manual identified no significant sleep disordered breathing in 40% of lean individuals with symptomatic OSA (AHI ≥5/h by 1999 'Chicago' criteria) and a favorable response to treatment. Two years have passed since the AASM Scoring Manual was published, garnering less criticism than was feared by those who developed it. The improvement in interscorer reliability using the Manual is heartening since this goal shaped many of the choices made. The alternative hypopnea rule should be endorsed as a recommended option. The AASM Scoring Manual provides a foundation upon which we all can build rules and methods that quantify the complexity of sleep and its disorders. Multicenter validation and refinement of the Manual is encouraged.

Enthalpy Costs of Making and Breaking Bonds: A Game of Generating Molecules with Proper Lewis Structures

ERIC Educational Resources Information Center

Bell, Peter T.; Adkins, Alyssa D.; Gamble, Rex J.; Schultz, Linda D.

2009-01-01

"Enthalpy Costs" is a simple card game created to assist students in developing proper Lewis structure drawing skills. Score keeping is accomplished by tracking the enthalpy changes associated with bond-making and bond-breaking processes during formation of molecules represented by proper Lewis structures. Playing the game requires the student to…

Associations between general parenting, restrictive snacking rules, and adolescent's snack intake. The roles of fathers and mothers and interparental congruence.

PubMed

Gevers, Dorus W M; van Assema, Patricia; Sleddens, Ester F C; de Vries, Nanne K; Kremers, Stef P J

2015-04-01

Little research has been done on the role of fathers and parenting congruence between mothers and fathers. This study aimed to clarify the roles of general parenting and restrictive snacking rules set by fathers and mothers, and to explore parenting congruence in explaining adolescents' snack intake. Adolescents aged 11 to 15 completed a questionnaire assessing their perception of general parenting constructs (i.e. nurturance, structure, behavioral control, coercive control, and overprotection), restrictive snacking rules set by their fathers and mothers, and their own energy-dense snack intakes between meals. Scores for mothers were significantly higher on all constructs than for fathers, except for coercive control. Generally, higher scores on general parenting constructs were associated with higher scores on restrictive snacking rules (most of the associations being significant). Most general parenting constructs were unrelated to the respondents' number of snacks consumed. The use of restrictive snacking rules by both fathers and mothers was significantly and negatively related to respondents' snack intake. Moderation analyses indicated that high levels of incongruence between parents attenuated the favorable impact of fathers' rules and nurturance on their children's snacking, but interactions of congruence with three other paternal scales and all maternal scales were absent. Our findings indicate that both paternal and maternal general parenting and restrictive snacking rules play important roles in adolescents' snacking, and that high parental incongruence regarding restrictive snacking rules and nurturance could be undesirable. Copyright © 2014 Elsevier Ltd. All rights reserved.

Simplified Mortality Score for the Intensive Care Unit (SMS-ICU): protocol for the development and validation of a bedside clinical prediction rule.

PubMed

Granholm, Anders; Perner, Anders; Krag, Mette; Hjortrup, Peter Buhl; Haase, Nicolai; Holst, Lars Broksø; Marker, Søren; Collet, Marie Oxenbøll; Jensen, Aksel Karl Georg; Møller, Morten Hylander

2017-03-09

Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU). During the first phase of the study, we will develop and internally validate a clinical prediction rule that predicts 90-day mortality on ICU admission. The development sample will comprise 4247 adult critically ill patients acutely admitted to the ICU, enrolled in 5 contemporary high-quality ICU studies/trials. The score will be developed using binary logistic regression analysis with backward stepwise elimination of candidate variables, and subsequently be converted into a point-based clinical prediction rule. The general performance, discrimination and calibration of the score will be evaluated, and the score will be internally validated using bootstrapping. During the second phase of the study, the score will be externally validated in a fully independent sample consisting of 3350 patients included in the ongoing Stress Ulcer Prophylaxis in the Intensive Care Unit trial. We will compare the performance of the SMS-ICU to that of existing scores. We will use data from patients enrolled in studies/trials already approved by the relevant ethical committees and this study requires no further permissions. The results will be reported in accordance with the Transparent Reporting of multivariate prediction models for Individual Prognosis Or Diagnosis (TRIPOD) statement, and submitted to a peer-reviewed journal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A departure from cognitivism: Implications of Chomsky's second revolution in linguistics.

PubMed

Schoneberger, T

2000-01-01

In 1957 Noam Chomsky published Syntactic Structures, expressing views characterized as constituting a "revolution" in linguistics. Chomsky proposed that the proper subject matter of linguistics is not the utterances of speakers, but what speakers and listeners know. To that end, he theorized that what they know is a system of rules that underlie actual performance. This theory became known as transformational grammar. In subsequent versions of this theory, rules continued to play a dominant role. However, in 1980 Chomsky began a second revolution by proposing the elimination of rules in a new theory: the principles-and-parameters approach. Subsequent writings finalized the abandonment of rules. Given the centrality of rules to cognitivism, this paper argues that Chomsky's second revolution constitutes a departure from cognitivism.

Evaluation of Different Scoring Rules for a Noncognitive Test in Development. Research Report. ETS RR-16-03

ERIC Educational Resources Information Center

Guo, Hongwen; Zu, Jiyun; Kyllonen, Patrick; Schmitt, Neal

2016-01-01

In this report, systematic applications of statistical and psychometric methods are used to develop and evaluate scoring rules in terms of test reliability. Data collected from a situational judgment test are used to facilitate the comparison. For a well-developed item with appropriate keys (i.e., the correct answers), agreement among various…

DOD Financial Management: Actions Under Way Need to Be Successfully Completed to Address Long-standing Funds Control Weaknesses

DTIC Science & Technology

2014-04-01

FISCAM Federal Information System Controls Audit Manual FMFIA Federal Managers’ Financial Integrity Act FMR Financial Management Regulation GAAP ...rules are incorporated into generally accepted accounting principles ( GAAP ) for the federal government. For additional information on the two methods of...to hold executive branch officials accountable for proper use of budgetary resources, and to ensure proper stewardship and transparency of the use

The Perception, Level of Safety Satisfaction and Safety Feedback on Occupational Safety and Health Management among Hospital Staff Nurses in Sabah State Health Department.

PubMed

Cheah, Whye Lian; Giloi, Nelbon; Chang, Ching Thon; Lim, Jac Fang

2012-07-01

This study aimed to determine the perception and level of safety satisfaction of staff nurses with regards to Occupational Safety and Health (OSH) management practice in the Sabah Health Department, and to associate the OSH management dimensions, to Safety Satisfaction and Safety Feedback. A cross-sectional study using a validated self-administered questionnaire was conducted among randomly respondents. 135 nurses responded the survey. Mean (SD) score for each dimension ranged from 1.70 ± 0.68-4.04 ± 0.65, with Training and Competence dimension (mean [SD], 4.04 ± 0.65) had the highest while Safety Incidence was the least score (mean [SD], 1.70 ± 0.68). Both mean (SD) scores for Safety Satisfaction and Safety Feedback was high, 3.28 ± 0.51 and 3.57 ± 0.73, respectively. Pearson's correlation analysis indicated that all OSH dimensions had significant correlation with Safety Satisfaction and Safety Feedback (r coefficient ranged from 0.176-0.512) except for Safety Incidence. The overall perception of OSH management was rather low. Significant correlation between Safety Satisfaction and Safety Feedback and several dimensions, suggest that each organization to put in place the leaders who have appropriate leadership and supervisory skills and committed in providing staff training to improve staff's competency in OSH practice. In addition, clear goals, rules, and reporting system will help the organization to implement proper OSH management practice.

Do surgeon interviewers have human factor-related issues during the long day UK National Trauma and Orthopaedic specialty recruitment process?

PubMed

Scrimgeour, D S G; Higgins, J; Bucknall, V; Arnett, R; Featherstone, C R; Cleland, J; Lee, A J; Brennan, P A

2018-03-05

The role that human factors (HF) play in contributing to medical error is increasingly being recognised by healthcare professionals. Surprisingly, much less is known about the possible effects of HF including boredom, fatigue and organisational influences, on performance outside of the clinical environment such as examining or assessing candidates in other high stakes situations. The authors used a validated 38 response questionnaire based around the HF analysis and classification system (HFACS) to assess factors including stress and pressure, care and support and working within the rules for surgeon interviewers at the UK national trainee selection process in Trauma and Orthopaedic surgery. 121 completed questionnaires were analysed (86% response rate). No statistically significant differences were found between interviewer experience, grade or role at the interview and the mean scores obtained for all four factor items. Overall interviewers had a positive experience during national selection with mean factor scores ranging from 3.80 to 3.98 (out of a maximum satisfaction score of 5). Careful planning by organisations and recognising the importance of the human element are essential to ensure assessors are looked after properly during high stakes assessment processes. Our data suggests that a positive experience for examiners is likely to benefit candidate performance and contribute to a fair and reliable recruitment process. The relationship between examiner experience and candidate performance merits further investigation. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

31 CFR 205.14 - When does Federal interest liability accrue?

Code of Federal Regulations, 2010 CFR

2010-07-01

... EFFICIENT FEDERAL-STATE FUNDS TRANSFERS Rules Applicable to Federal Assistance Programs Included in a... funding technique properly, we may deny any resulting Federal interest liability, notwithstanding any...

Automated classification of MMPI profiles into psychotic, neurotic or personality disorder types.

PubMed

Hatcher, W E

1978-03-01

A Fortran program has been developed which can objectively classify Minnesota Multiphasic Inventory (MMPI) profiles as being psychotic, neurotic, personality disorder, or indeterminate types. The method used is a set of configural rules, 'Henrichs' rules for males'. The only input data required are K-corrected T scores, which are the end product of standard scoring techniques. To automate these rules it was necessary to rewrite them so that all decisions were the result of arithmetic comparisons or logical tests using only and, or and not. In particular, examination of the Welsh code, which many rules required, had to be stimulated by the use of several sorted arrays. The program has been carefully tested and is in the use in our computer lab.

PubMed Central

PANATTO, D.; ARATA, L.; BEVILACQUA, I.; APPRATO, L.; GASPARINI, R.; AMICIZIA, D.

2015-01-01

Summary Introduction. Health-related knowledge is often assessed through multiple-choice tests. Among the different types of formats, researchers may opt to use multiple-mark items, i.e. with more than one correct answer. Although multiple-mark items have long been used in the academic setting – sometimes with scant or inconclusive results – little is known about the implementation of this format in research on in-field health education and promotion. Methods. A study population of secondary school students completed a survey on nutrition-related knowledge, followed by a single- lecture intervention. Answers were scored by means of eight different scoring algorithms and analyzed from the perspective of classical test theory. The same survey was re-administered to a sample of the students in order to evaluate the short-term change in their knowledge. Results. In all, 286 questionnaires were analyzed. Partial scoring algorithms displayed better psychometric characteristics than the dichotomous rule. In particular, the algorithm proposed by Ripkey and the balanced rule showed greater internal consistency and relative efficiency in scoring multiple-mark items. A penalizing algorithm in which the proportion of marked distracters was subtracted from that of marked correct answers was the only one that highlighted a significant difference in performance between natives and immigrants, probably owing to its slightly better discriminatory ability. This algorithm was also associated with the largest effect size in the pre-/post-intervention score change. Discussion. The choice of an appropriate rule for scoring multiple- mark items in research on health education and promotion should consider not only the psychometric properties of single algorithms but also the study aims and outcomes, since scoring rules differ in terms of biasness, reliability, difficulty, sensitivity to guessing and discrimination. PMID:26900331

CHA2 DS2 -VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule-out.

PubMed

Topaz, Guy; Haisraely, Ory; Shacham, Yacov; Beery, Gil; Shilo, Lotan; Kassem, Nuha; Pereg, David; Kitay-Cohen, Yona

2018-04-01

Chest-pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes. CHA 2 DS 2 -VASc score improves risk stratification of low-risk chest-pain patients discharged after acute coronary syndrome (ACS) rule-out. We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010-2016 and discharged following an ACS rule-out. Patients were classified according to CHA 2 DS 2 -VASc score: 0-1 (low), 2-3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30-day and 1-year all-cause mortality (ACM) were secondary outcomes. Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA 2 DS 2 -VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1-year ACS during the first year (OR: 2.89, 95% CI: 1.91-4.37, P < 0.01 and OR: 4.84, 95% CI: 3.02-7.74, P < 0.01, respectively). Each 1-point increase in CHA 2 DS 2 -VASc was associated with a 37% increased risk for 1-year ACS. A higher CHA 2 DS 2 -VASc score was associated with significantly higher 30-day ACM. Hazard ratios for 30-day ACM were 1.9 (95% CI: 1.1-3.4, P = 0.03) and 4.4 (95% CI: 2.4-7.9, P < 0.01) for intermediate and high CHA 2 DS 2 -VASc scores, respectively, compared with a low score. Each 1-point increase in CHA 2 DS 2 -VASc score was associated with 43% increased risk for 30-day mortality. High CHA 2 DS 2 -VASc score (>3) was associated with adverse outcomes among chest-pain patients discharged from internal medicine wards following ACS rule-out. © 2018 Wiley Periodicals, Inc.

Examining Initial Sleep Onset in Primary Insomnia: A Case-Control Study Using 4-Second Epochs

PubMed Central

Moul, Douglas E.; Germain, Anne; Cashmere, J. David; Quigley, Michael; Miewald, Jean M.; Buysse, Daniel J.

2007-01-01

Study Objectives: To explore the sleep onset process in primary insomnia patients, new rules for scoring 4-second epochs were implemented to score sleep and artifacts during initial sleep onset. Conventional scorings in 20-second and 60-second epochs were also obtained. Methods: The start of the initial 60-second epoch of stage 1 was used to define “time zero” (t0). Sleep onset periods from 11 patients and 11 individually age- and sex-matched controls spanned from 5 minutes before t0 through 29 minutes after t0. Using the new rules, the periods were scored blind to group assignment. This t0 time-referenced the data analysis to one plausible midpoint in the sleep onset process. In parallel, latencies were time-referenced from good night time. Results: Reliability in scoring sleep and artifacts was adequate (kappa = 0.68 & 0.63, respectively, p <0.001). Group differences in sleep latencies were marginal in 60-second and 20-second scoring but significant with a definition of 4-second sleep latency. Patients had more 4-second epochs scored as awake (Mantel-Haenszel χ2 = 271, d.f. = 1, p <0.001) and containing artifact (M-H χ2 = 143, p <0.001). Patients took longer to achieve 30 continuous 4-second epochs of NREM sleep (Breslow χ2 = 4.03, d.f. = 1, p = 0.045) after t0. Patients accumulated sleep more slowly with all 3 scoring rules after t0. A slower rate of accumulating sleep after t0 was detected only with the 4-second scoring (p = 0.047). Conclusions: Evidence was present for momentary state-switching instabilities in the patients during the initial sleep onset process. Using rules for scoring small epochs may reveal such instabilities more readily than traditional scoring methods. Citation: Moul DE; Germain A; Cashmere D; Quigley M; Miewald JM; Buysse DJ. Examining initial sleep onset in primary insomnia: a case-control study using 4-second epochs. J Clin Sleep Med 2007;3(5):479-488. PMID:17803011

A departure from cognitivism: Implications of Chomsky's second revolution in linguistics

PubMed Central

Schoneberger, Ted

2000-01-01

In 1957 Noam Chomsky published Syntactic Structures, expressing views characterized as constituting a “revolution” in linguistics. Chomsky proposed that the proper subject matter of linguistics is not the utterances of speakers, but what speakers and listeners know. To that end, he theorized that what they know is a system of rules that underlie actual performance. This theory became known as transformational grammar. In subsequent versions of this theory, rules continued to play a dominant role. However, in 1980 Chomsky began a second revolution by proposing the elimination of rules in a new theory: the principles-and-parameters approach. Subsequent writings finalized the abandonment of rules. Given the centrality of rules to cognitivism, this paper argues that Chomsky's second revolution constitutes a departure from cognitivism. PMID:22477214

National Board Scores versus Student GPA's in Chiropractic Education.

ERIC Educational Resources Information Center

Kalthoff, Theodore J.

1985-01-01

The relationship between student GPAs and scores on the National Board of Chiropractic Examiners tests was investigated in an effort to determine if the chiropractic curriculum was properly preparing students to be licensed. The study found that there was a significant correlation between GPAs and board scores. (Author/MLW)

Are Medical Students Assigning Proper Global Assessment of Functioning Scores?

ERIC Educational Resources Information Center

Warsi, Mustafa K.; Sattar, S. Pirzada; Din, Amad U.; Petty, Frederick; Padala, Prasad R.

2007-01-01

Objective: This article seeks to determine whether medical students can estimate the appropriate score for the Global Assessment of Functioning (GAF) compared with psychiatry residents and staff psychiatrists. The authors hypothesized that medical students' estimations of GAF scores for patients in clinical vignettes would differ from those…

A Rule-Based Modeling for the Description of Flexible and Self-healing Business Processes

NASA Astrophysics Data System (ADS)

Boukhebouze, Mohamed; Amghar, Youssef; Benharkat, Aïcha-Nabila; Maamar, Zakaria

In this paper we discuss the importance of ensuring that business processes are label robust and agile at the same time robust and agile. To this end, we consider reviewing the way business processes are managed. For instance we consider offering a flexible way to model processes so that changes in regulations are handled through some self-healing mechanisms. These changes may raise exceptions at run-time if not properly reflected on these processes. To this end we propose a new rule based model that adopts the ECA rules and is built upon formal tools. The business logic of a process can be summarized with a set of rules that implement an organization’s policies. Each business rule is formalized using our ECAPE formalism (Event-Condition-Action-Post condition- post Event). This formalism allows translating a process into a graph of rules that is analyzed in terms of reliably and flexibility.

Standard of care of erectile dysfunction in U.S. Air Force aircrew and active duty not on flying status.

PubMed

Nast, Justin B

2014-11-01

In 2011, over 3,000 active duty U.S. Air Force (USAF) members were prescribed a phosphodiesterase inhibitor (PDEI). PDEIs are first-line therapy for treating erectile dysfunction and can have significant side effects that could impact aircrew performance. In total, 200 eligible subject records were randomly sampled from the active duty USAF population of those males filling a prescription for a PDEI in June 2011; 100 of those records were from aviators. The electronic records were reviewed and scored to determine if USAF aeromedical standards for prescribing PDEIs were followed, with a minimum score of 0 for no standards met and a maximum of 3 for all standards met. The average score for both groups was 1, with no significant difference between the group scores. A proper aeromedical disposition was documented in 67% of the aviator records. Although there was no significant difference in standard of care for aviators and nonaviators, the overall documented standard of care was poor. Lack of documentation was the primary reason for the low scores and the low percentage of properly rendered aeromedical dispositions. Proper medical record documentation is important for evaluating quality of care and ensuring compliance with regulations in an Air Force aviator population. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

[Clinical score to rule out pneumonia due to Mycoplasma pneumoniae].

PubMed

Rodríguez de Ita, J; Torres-Quintanilla, A; Paláu-Dávila, L; Silva-Gburek, J C; Ortiz de Elguea-Lizarraga, J; Chávez Caraza, K L; Santos-Guzman, J

2014-10-01

The gold standard for the diagnosis of pneumonia secondary to Mycoplasma pneumoniae is the serial measurement of IgM, since an isolated test for IgM has a poor sensitivity of 31.8%. A pneumonia due to Mycoplasma pneumoniae could be of clinically different origins, thus it is possible to perform a clinical score for its early diagnosis. To develop a clinical score in order to rule out a pneumoniae secondary to Mycoplasma pneumoniae. A total of 302 patients from 0 to 18 years-old, with a diagnosis of pneumonia were evaluated and divided into two groups: Mycoplasma positive and Mycoplasma negative. Using different variables in the medical records a clinical score was calculated. Of the 302 cases studied, 34 were classified as Mycoplasma positive and 268 as Mycoplasma negative. The variables relevant to the calculation of the score were age, days with fever, and days with cough, thus providing the CAF (Cough, Age, Fever) score. Ranges were assigned for each variable and points were given for each range. A value greater than or equal to 5 meant a positive score. The CAF score was applied to the 302 cases, resulting in 164 cases of Mycoplasma positive and 138 cases of Mycoplasma negative. The CAF score had a sensitivity of 85% and specificity of 49%. The CAF score had better sensitivity than other clinical diagnostic tools. With a negative predictive value of 96% it is possible to rule out a pneumonia secondary to M. pneumoniae. The study requires a prospective study to verify the usefulness of our score. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Olympic Scoring of English Compositions

ERIC Educational Resources Information Center

Follman, John; Panther, Edward

1974-01-01

Examines empirically the efficacy of utilizing Olympic diving and gymnastic scoring systems for grading graduate students' English compositions. Results indicated that such scoring rules do not produce ratings different in reliability or in level from conventional letter grades. (ED)

Performance scores and standings during the 43rd Artistic Gymnastics World Championships, 2011.

PubMed

Massidda, Myosotis; Calò, Carla M

2012-01-01

Scores in artistic gymnastics are subject to changes in the rules that occur each Olympic cycle as outlined in the Code of Points, because rules influence the composition of routines and therefore performance. The aim of this study was to identify the most important routine apparatus for success in a World competition. The data were the official results for the 478 gymnasts (262 men, 216 women) who competed in the 43rd Artistic Gymnastic World Championships in 2011 in Tokyo, Japan. The factors least influenced by the technical standard of competitors were performance scores on uneven bars and balance beam for women, and those on pommel horse for men. For uneven bars, balance beam, and pommel horse, scores were consistently good predictors of final standing. Our results suggest that high scores on these apparatus have a greater influence on overall performance than scores on the other apparatus, regardless of the competitors' standard.

Vietnamese children and language-based processing tasks.

PubMed

Hwa-Froelich, Deborah A; Matsuo, Hisako

2005-07-01

Vietnamese children's performance on language-based processing tasks of fast-mapping (FM) word-learning and dynamic assessment (DA) word- and rule-learning tasks were investigated. Twenty-one first- and second-generation Vietnamese preschool children participated in this study. All children were enrolled in 2 Head Start programs in a large city in the Midwest. All children had passed a developmental assessment and routine speech, language, and hearing screenings. All participants were taught 4 invented monosyllabic words in an FM word task, an invented monosyllabic suffix rule (-po) meaning "a part of" in a DA rule task, and 4 invented bisyllabic words in a DA word task. Potential relationships among task performances were investigated. Receptive task performances, expressive task performances, and task totals were added to create receptive total, expressive total, and accumulated performance total (APT) scores. Relationships among receptive total, expressive total, and APT scores were also investigated. Significant correlations were found between FM word, DA rule, and the receptive total. The expressive total correlated with all task total scores, APT, age, and modifiability scores. Modifiability scores correlated with the two DA tasks, expressive total, and the APT. Findings indicate that FM word and the expressive total were positively correlated with most of the other tasks, composite totals, and age. Performance on language-based processing tasks may provide valuable information for separating typically developing Vietnamese preschool children from their peers with language disorders. Practitioners should consider linguistic characteristics of target stimuli. Comparisons should include task, receptive, expressive, and APT.

QoE collaborative evaluation method based on fuzzy clustering heuristic algorithm.

PubMed

Bao, Ying; Lei, Weimin; Zhang, Wei; Zhan, Yuzhuo

2016-01-01

At present, to realize or improve the quality of experience (QoE) is a major goal for network media transmission service, and QoE evaluation is the basis for adjusting the transmission control mechanism. Therefore, a kind of QoE collaborative evaluation method based on fuzzy clustering heuristic algorithm is proposed in this paper, which is concentrated on service score calculation at the server side. The server side collects network transmission quality of service (QoS) parameter, node location data, and user expectation value from client feedback information. Then it manages the historical data in database through the "big data" process mode, and predicts user score according to heuristic rules. On this basis, it completes fuzzy clustering analysis, and generates service QoE score and management message, which will be finally fed back to clients. Besides, this paper mainly discussed service evaluation generative rules, heuristic evaluation rules and fuzzy clustering analysis methods, and presents service-based QoE evaluation processes. The simulation experiments have verified the effectiveness of QoE collaborative evaluation method based on fuzzy clustering heuristic rules.

New scheduling rules for a dynamic flexible flow line problem with sequence-dependent setup times

NASA Astrophysics Data System (ADS)

Kia, Hamidreza; Ghodsypour, Seyed Hassan; Davoudpour, Hamid

2017-09-01

In the literature, the application of multi-objective dynamic scheduling problem and simple priority rules are widely studied. Although these rules are not efficient enough due to simplicity and lack of general insight, composite dispatching rules have a very suitable performance because they result from experiments. In this paper, a dynamic flexible flow line problem with sequence-dependent setup times is studied. The objective of the problem is minimization of mean flow time and mean tardiness. A 0-1 mixed integer model of the problem is formulated. Since the problem is NP-hard, four new composite dispatching rules are proposed to solve it by applying genetic programming framework and choosing proper operators. Furthermore, a discrete-event simulation model is made to examine the performances of scheduling rules considering four new heuristic rules and the six adapted heuristic rules from the literature. It is clear from the experimental results that composite dispatching rules that are formed from genetic programming have a better performance in minimization of mean flow time and mean tardiness than others.

Research directed toward improved echelles for the ultraviolet. [large space teslescope spectrographs

NASA Technical Reports Server (NTRS)

1977-01-01

Low frequency gratings obtainable with present technology, can meet the grating-efficiency design goals for potential space telescope spectrographs. Gratings made with changes in the three specific parameters: the ruling tool profile, the coating material, and the lubricants used during the ruling process were compared. A series of coatings and test gratings were fabricated and were examined for surface smoothness with a Nomarski differential interference microscope and an electron microsocope. Photomicrographs were obtained to show the difference in smoothness of the various coatings and rulings. Efficiency measurements were made for those test rulings that showed good groove characteristics: smoothness, proper ruling depth, and absence of defects (e.g., streaks, feathered edges and rough sides). Higher grating efficiency should be correlated with the degree of smoothness of both the coating and the grating groove.

Evaluation of ensemble forecast uncertainty using a new proper score: application to medium-range and seasonal forecasts

NASA Astrophysics Data System (ADS)

Christensen, Hannah; Moroz, Irene; Palmer, Tim

2015-04-01

Forecast verification is important across scientific disciplines as it provides a framework for evaluating the performance of a forecasting system. In the atmospheric sciences, probabilistic skill scores are often used for verification as they provide a way of unambiguously ranking the performance of different probabilistic forecasts. In order to be useful, a skill score must be proper -- it must encourage honesty in the forecaster, and reward forecasts which are reliable and which have good resolution. A new score, the Error-spread Score (ES), is proposed which is particularly suitable for evaluation of ensemble forecasts. It is formulated with respect to the moments of the forecast. The ES is confirmed to be a proper score, and is therefore sensitive to both resolution and reliability. The ES is tested on forecasts made using the Lorenz '96 system, and found to be useful for summarising the skill of the forecasts. The European Centre for Medium-Range Weather Forecasts (ECMWF) ensemble prediction system (EPS) is evaluated using the ES. Its performance is compared to a perfect statistical probabilistic forecast -- the ECMWF high resolution deterministic forecast dressed with the observed error distribution. This generates a forecast that is perfectly reliable if considered over all time, but which does not vary from day to day with the predictability of the atmospheric flow. The ES distinguishes between the dynamically reliable EPS forecasts and the statically reliable dressed deterministic forecasts. Other skill scores are tested and found to be comparatively insensitive to this desirable forecast quality. The ES is used to evaluate seasonal range ensemble forecasts made with the ECMWF System 4. The ensemble forecasts are found to be skilful when compared with climatological or persistence forecasts, though this skill is dependent on region and time of year.

Comparison of American Academy of Sleep Medicine (AASM) versus Center for Medicare and Medicaid Services (CMS) polysomnography (PSG) scoring rules on AHI and eligibility for continuous positive airway pressure (CPAP) treatment.

PubMed

Korotinsky, Arkady; Assefa, Samson Z; Diaz-Abad, Montserrat; Wickwire, Emerson M; Scharf, Steven M

2016-12-01

Obstructive sleep apnea (OSA) is an important clinical condition. Eligibility for treatment usually depends on disease severity, measured as the apnea-hypopnea index (AHI), equal to the sum of apneas plus hypopneas per hour of sleep. There is divergence on scoring rules for hypopneas between the recommendations of the American Academy of Sleep Medicine (AASM) and the Center for Medicare Services (CMS), the latter being more restrictive. Thus, patients could be eligible for treatment under AASM rules, but not under CMS rules. Sleep laboratory records of 112 consecutive patients were reviewed (85 < 65, 27 ≥ 65 years old). AHI was calculated both by AASM and by CMS criteria. Information on demographics, and important comorbidities, was also reviewed. AHI was lower in younger patients using CMS criteria. However, differences in AHI using the two sets of criteria were not significantly different in the older patients. Incorporating all criteria for eligibility (severity, presence of certain comorbid conditions) for treatment, we found that fewer younger patients would be eligible using CMS criteria, but among the older patients, eligibility for treatment was the same whether AASM or CMS criteria were used. Use of CMS criteria for scoring hypopneas results in lower estimates of OSA severity, with fewer younger patients eligible for treatment. However, among Medicare age patients, the rate of treatment eligibility was the same whether AASM or CMS scoring rules were used.

Daisy Shooting Education. 10 Lesson Curriculum.

ERIC Educational Resources Information Center

Narcheaur, Mary Elizabeth; And Others

This instructor's manual is a ten lesson curriculum designed to instruct young shooters in the skills of proper gun handling and marksmanship. Gunology (knowledge of guns and ammunition) and rules for air rifle competition are also discussed. (CJ)

School age child development (image)

MedlinePlus

School age child development is a range from 6 to 12 years of age. During this time period observable differences in height, ... peers. As always, safety is important in school age children and proper safety rules should be enforced ...

29 CFR 4.101 - Official rulings and interpretations in this subpart.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 23, 1976, 41 FR 9016). These interpretations are a proper exercise of the Secretary's authority... the fact that a subject or illustration is omitted. (g) It should not be assumed that the lack of...

Evaluation of heparin-induced thrombocytopenia (HIT) laboratory testing and the 4Ts scoring system in the intensive care unit.

PubMed

Pierce, Wesly; Mazur, Joseph; Greenberg, Charles; Mueller, Joan; Foster, Joyce; Lazarchick, John

2013-01-01

Over-diagnosis of heparin-induced thrombocytopenia (HIT) results in costly and unnecessary laboratory screening and treatment with direct thrombin inhibitors. Our aim was to evaluate the utility of the 4Ts scoring system to predict HIT in multiple ICU settings and to characterize our treatment of these cases. Eighty-two patients from multiple ICU settings who underwent laboratory testing for HIT were classified as low-, intermediate-, or high-risk patients based on retrospectively adjudicated 4Ts scores. These results were compared with platelet-factor 4 enzyme-linked immunosorbent assays (PF4 ELISAs), optical density (OD) values, and serotonin-release assays (SRAs) to assess the utility of the 4Ts score to rule out ICU-related HIT and reduce laboratory and drug expenditures. Of the 82 patients reviewed, only 12 (11.4%) were PF4-positive and only 1 (1.2%) was SRA-positive for HIT. Heparin was discontinued in only 63.4% of patients suspected to have HIT. There were no significant differences in mean day of platelet fall, mean platelet nadir, and mean percent fall in platelet count between PF4-positive and negative patients (all p > 0.2). There was, however, a significantly higher proportion of patients with an intermediate to high 4Ts score in the PF4-positive group than in the PF4-negative group (66% vs. 30%, respectively; p = 0.02). The mean PF4 OD value in patients with intermediate to high 4Ts scores was significantly higher than in patients with low 4Ts scores (0.658 vs. 0.258, respectively; p < 0.001). The negative predictive values of the 4Ts score relative to the PF4 and SRA were 92% and 100%, respectively. The estimated laboratory and pharmacologic cost avoidance potential of the scoring system in this cohort was $21,450. Our modified 4Ts scoring system appears to be an effective tool for predicting HIT in the ICU and could avoid significant drug and laboratory expenditures if implemented prospectively. The clinical management of patients suspected of HIT is highly variable at our institution. Clinical protocols and education encouraging the proper identification and treatment of suspected HIT need to be established.

World Association of Sleep Medicine (WASM) 2016 standards for recording and scoring leg movements in polysomnograms developed by a joint task force from the International and the European Restless Legs Syndrome Study Groups (IRLSSG and EURLSSG).

PubMed

Ferri, R; Fulda, S; Allen, R P; Zucconi, M; Bruni, O; Chokroverty, S; Ferini-Strambi, L; Frauscher, B; Garcia-Borreguero, D; Hirshkowitz, M; Högl, B; Inoue, Y; Jahangir, A; Manconi, M; Marcus, C L; Picchietti, D L; Plazzi, G; Winkelman, J W; Zak, R S

2016-10-01

This report presents the results of the work by a joint task force of the International and European Restless Legs Syndrome Study Groups and World Association of Sleep Medicine that revised and updated the current standards for recording and scoring leg movements (LM) in polysomnographic recordings (PSG). First, the background of the decisions made and the explanations of the new rules are reported and then specific standard rules are presented for recording, detecting, scoring and reporting LM activity in PSG. Each standard rule has been classified with a level of evidence. At the end of the paper, Appendix 1 provides algorithms to aid implementation of these new standards in software tools. There are two main changes introduced by these new rules: 1) Candidate LM (CLM), are any monolateral LM 0.5-10 s long or bilateral LM 0.5-15 s long; 2) periodic LM (PLM) are now defined by runs of at least four consecutive CLM with an intermovement interval ≥10 and ≤ 90 s without any CLM preceded by an interval <10 s interrupting the PLM series. There are also new options defining CLM associated with respiratory events. The PLM rate may now first be determined for all CLM not excluding any related to respiration (providing a consistent number across studies regardless of the rules used to define association with respiration) and, subsequently, the PLM rate should also be calculated without considering the respiratory related events. Finally, special considerations for pediatric studies are provided. The expert visual scoringof LM has only been altered by the new standards to require accepting all LM > 0.5 s regardless of duration, otherwise the technician scores the LM as for the old standards. There is a new criterion for the morphology of LM that applies only to computerized LM detection to better match expert visual detection. Available automatic scoring programs will incorporate all the new rules so that the new standards should reduce technician burden for scoring PLMS. Copyright © 2016 Elsevier B.V. All rights reserved.

Official Basketball Rules for Girls and Women. July 1972 - July 1973. Reprint.

ERIC Educational Resources Information Center

American Association for Health, Physical Education, and Recreation, Washington, DC. Div. for Girls and Women's Sports.

The official American Association for Health, Physical Education, and Recreation (AAHPER) rules for girls and women's basketball, July 1972 - July 1973 are listed. Exact court measurements are given as are official scoring rules, timing procedures, duties of officials, definition of playing terms, violations and penalties, and officials' signals.…

Interpreting Self-Directed Search Profiles: Validity of the "Rule of Eight"

ERIC Educational Resources Information Center

Glavin, Kevin W.; Savickas, Mark L.

2011-01-01

Based on the standard error of measurement, Holland (1985) suggested the "rule of eight" for determining the meaningfulness of differences between two summary scores on the Self Directed Search. The present study empirically examined the rule's validity for practice. The participants were 2397 (1497 females and 900 males) undergraduate…

U. S. Office of Personnel Management and the Merit System: A retrospective Assessment. A Report Concerning Significant Actions of the Office of Personnel Management

DTIC Science & Technology

1989-06-01

agencies are performing properly passage of the CSRA, was characterized in a 1978 under civil service laws, regulations , and Presidential statement as...talent.3 It assigned OPM responsibility for "executing, ad- ministering, and enforcing the civil service rules and regulations of the President," and...performing properly under civil serv- ice laws, regulations , and delegated authorities." 4 a Conduct or facilitate the conduct of research avid

The Perception, Level of Safety Satisfaction and Safety Feedback on Occupational Safety and Health Management among Hospital Staff Nurses in Sabah State Health Department

PubMed Central

Cheah, Whye Lian; Giloi, Nelbon; Chang, Ching Thon; Lim, Jac Fang

2012-01-01

Background: This study aimed to determine the perception and level of safety satisfaction of staff nurses with regards to Occupational Safety and Health (OSH) management practice in the Sabah Health Department, and to associate the OSH management dimensions, to Safety Satisfaction and Safety Feedback. Methods: A cross-sectional study using a validated self-administered questionnaire was conducted among randomly respondents. Results: 135 nurses responded the survey. Mean (SD) score for each dimension ranged from 1.70 ± 0.68–4.04 ± 0.65, with Training and Competence dimension (mean [SD], 4.04 ± 0.65) had the highest while Safety Incidence was the least score (mean [SD], 1.70 ± 0.68). Both mean (SD) scores for Safety Satisfaction and Safety Feedback was high, 3.28 ± 0.51 and 3.57 ± 0.73, respectively. Pearson’s correlation analysis indicated that all OSH dimensions had significant correlation with Safety Satisfaction and Safety Feedback (r coefficient ranged from 0.176–0.512) except for Safety Incidence. Conclusion: The overall perception of OSH management was rather low. Significant correlation between Safety Satisfaction and Safety Feedback and several dimensions, suggest that each organization to put in place the leaders who have appropriate leadership and supervisory skills and committed in providing staff training to improve staff’s competency in OSH practice. In addition, clear goals, rules, and reporting system will help the organization to implement proper OSH management practice. PMID:23610550

Traditional versus rule-based programming techniques: Application to the control of optional flight information

NASA Technical Reports Server (NTRS)

Ricks, Wendell R.; Abbott, Kathy H.

1987-01-01

To the software design community, the concern over the costs associated with a program's execution time and implementation is great. It is always desirable, and sometimes imperative, that the proper programming technique is chosen which minimizes all costs for a given application or type of application. A study is described that compared cost-related factors associated with traditional programming techniques to rule-based programming techniques for a specific application. The results of this study favored the traditional approach regarding execution efficiency, but favored the rule-based approach regarding programmer productivity (implementation ease). Although this study examined a specific application, the results should be widely applicable.

Stochastic Dominance and Analysis of ODI Batting Performance: the Indian Cricket Team, 1989-2005

PubMed Central

Damodaran, Uday

2006-01-01

Relative to other team games, the contribution of individual team members to the overall team performance is more easily quantifiable in cricket. Viewing players as securities and the team as a portfolio, cricket thus lends itself better to the use of analytical methods usually employed in the analysis of securities and portfolios. This paper demonstrates the use of stochastic dominance rules, normally used in investment management, to analyze the One Day International (ODI) batting performance of Indian cricketers. The data used span the years 1989 to 2005. In dealing with cricketing data the existence of ‘not out’ scores poses a problem while processing the data. In this paper, using a Bayesian approach, the ‘not-out’ scores are first replaced with a conditional average. The conditional average that is used represents an estimate of the score that the player would have gone on to score, if the ‘not out’ innings had been completed. The data thus treated are then used in the stochastic dominance analysis. To use stochastic dominance rules we need to characterize the ‘utility’ of a batsman. The first derivative of the utility function, with respect to runs scored, of an ODI batsman can safely be assumed to be positive (more runs scored are preferred to less). However, the second derivative needs not be negative (no diminishing marginal utility for runs scored). This means that we cannot clearly specify whether the value attached to an additional run scored is lesser at higher levels of scores. Because of this, only first-order stochastic dominance is used to analyze the performance of the players under consideration. While this has its limitation (specifically, we cannot arrive at a complete utility value for each batsman), the approach does well in describing player performance. Moreover, the results have intuitive appeal. Key Points The problem of dealing with ‘not out’ scores in cricket is tackled using a Bayesian approach. Stochastic dominance rules are used to characterize the utility of a batsman. Since the marginal utility of runs scored is not diminishing in nature, only first order stochastic dominance rules are used. The results, demonstrated using data for the Indian cricket team are intuitively appealing. The limitation of the approach is that it cannot arrive at a complete utility value for the batsman. PMID:24357944

Stochastic Dominance and Analysis of ODI Batting Performance: the Indian Cricket Team, 1989-2005.

PubMed

Damodaran, Uday

2006-01-01

Relative to other team games, the contribution of individual team members to the overall team performance is more easily quantifiable in cricket. Viewing players as securities and the team as a portfolio, cricket thus lends itself better to the use of analytical methods usually employed in the analysis of securities and portfolios. This paper demonstrates the use of stochastic dominance rules, normally used in investment management, to analyze the One Day International (ODI) batting performance of Indian cricketers. The data used span the years 1989 to 2005. In dealing with cricketing data the existence of 'not out' scores poses a problem while processing the data. In this paper, using a Bayesian approach, the 'not-out' scores are first replaced with a conditional average. The conditional average that is used represents an estimate of the score that the player would have gone on to score, if the 'not out' innings had been completed. The data thus treated are then used in the stochastic dominance analysis. To use stochastic dominance rules we need to characterize the 'utility' of a batsman. The first derivative of the utility function, with respect to runs scored, of an ODI batsman can safely be assumed to be positive (more runs scored are preferred to less). However, the second derivative needs not be negative (no diminishing marginal utility for runs scored). This means that we cannot clearly specify whether the value attached to an additional run scored is lesser at higher levels of scores. Because of this, only first-order stochastic dominance is used to analyze the performance of the players under consideration. While this has its limitation (specifically, we cannot arrive at a complete utility value for each batsman), the approach does well in describing player performance. Moreover, the results have intuitive appeal. Key PointsThe problem of dealing with 'not out' scores in cricket is tackled using a Bayesian approach.Stochastic dominance rules are used to characterize the utility of a batsman.Since the marginal utility of runs scored is not diminishing in nature, only first order stochastic dominance rules are used.The results, demonstrated using data for the Indian cricket team are intuitively appealing.The limitation of the approach is that it cannot arrive at a complete utility value for the batsman.

Making the Cut in Gifted Selection: Score Combination Rules and Their Impact on Program Diversity

ERIC Educational Resources Information Center

Lakin, Joni M.

2018-01-01

The recommendation of using "multiple measures" is common in policy guidelines for gifted and talented assessment systems. However, the integration of multiple test scores in a system that uses cut-scores requires choosing between different methods of combining quantitative scores. Past research has indicated that OR combination rules…

Factors affecting unplanned readmissions from community hospitals to acute hospitals: a prospective observational study.

PubMed

Leong, Ian Y O; Chan, Siew-Pang; Tan, Boon-Yeow; Sitoh, Yih-Yiow; Ang, Yan-Hoon; Merchant, Reshma; Kanagasabai, Kala; Lee, Patricia S Y; Pang, Weng-Sun

2009-02-01

While the readmission rate from community hospitals is known, the factors affecting it are not. Our aim was to determine the factors predicting unplanned readmissions from community hospitals (CHs) to acute hospitals (AHs). This was an observational prospective cohort study, involving 842 patients requiring post-acute rehabilitation in 2 CHs admitted from 3 AHs in Singapore. We studied the role of the Cumulative Illness Rating Scale (CIRS) organ impairment scores, the Mini-mental State Examination (MMSE) score, the Shah modified Barthel Index (BI) score, and the triceps skin fold thickness (TSFT) in predicting the rate of unplanned readmissions (UR), early unplanned readmissions (EUPR) and late unplanned readmissions (LUPR). We developed a clinical prediction rule to determine the risk of UR and EUPR. The rates of EUPR and LUPR were 7.6% and 10.3% respectively. The factors that predicted UR were the CIRS-heart score, the CIRS-haemopoietic score, the CIRS-endocrine / metabolic score and the BI on admission. The MMSE was predictive of EUPR. The TSFT and CIRS-liver score were predictive of LUPR. Upon receiver operator characteristics analysis, the clinical prediction rules for the prediction of EUPR and UR had areas under the curve of 0.745 and 0.733 respectively. The likelihood ratios of the clinical prediction rules for EUPR and UR ranged from 0.42 to 5.69 and 0.34 to 3.16 respectively. Patients who have UR can be identified by the admission BI, the MMSE, the TSFT and CIRS scores in the cardiac, haemopoietic, liver and endocrine/metabolic systems.

The PLAN score: a bedside prediction rule for death and severe disability following acute ischemic stroke.

PubMed

O'Donnell, Martin J; Fang, Jiming; D'Uva, Cami; Saposnik, Gustavo; Gould, Linda; McGrath, Emer; Kapral, Moira K

2012-11-12

We sought to develop and validate a simple clinical prediction rule for death and severe disability after acute ischemic stroke that can be used by general clinicians at the time of hospital admission. We analyzed data from a registry of 9847 patients (4943 in the derivation cohort and 4904 in the validation cohort) hospitalized with acute ischemic stroke and included in the Registry of the Canadian Stroke Network (July 1, 2003, to March 31, 2008; 11 regional stroke centers in Ontario, Canada). Outcome measures were 30-day and 1-year mortality and a modified Rankin score of 5 to 6 at discharge. Overall 30-day mortality was 11.5% (derivation cohort) and 13.5% (validation cohort). In the final multivariate model, we included 9 clinical variables that could be categorized as preadmission comorbidities (5 points for preadmission dependence [1.5], cancer [1.5], congestive heart failure [1.0], and atrial fibrillation [1.0]), level of consciousness (5 points for reduced level of consciousness), age (10 points, 1 point/decade), and neurologic focal deficit (5 points for significant/total weakness of the leg [2], weakness of the arm [2], and aphasia or neglect [1]). Maximum score is 25. In the validation cohort, the PLAN score (derived from preadmission comorbidities, level of consciousness, age, and neurologic deficit) predicted 30-day mortality (C statistic, 0.87), death or severe dependence at discharge (0.88), and 1-year mortality (0.84). The PLAN score also predicted favorable outcome (modified Rankin score, 0-2) at discharge (C statistic, 0.80). The PLAN clinical prediction rule identifies patients who will have a poor outcome after hospitalization for acute ischemic stroke. The score comprises clinical data available at the time of admission and may be determined by nonspecialist clinicians. Additional studies to independently validate the PLAN rule in different populations and settings are required.

Using Empirical Data to Set Cutoff Scores.

ERIC Educational Resources Information Center

Hills, John R.

Six experimental approaches to the problems of setting cutoff scores and choosing proper test length are briefly mentioned. Most of these methods share the premise that a test is a random sample of items, from a domain associated with a carefully specified objective. Each item is independent and is scored zero or one, with no provision for…

A probabilistic method to diagnose faults of air handling units

NASA Astrophysics Data System (ADS)

Dey, Debashis

Air handling unit (AHU) is one of the most extensively used equipment in large commercial buildings. This device is typically customized and lacks quality system integration which can result in hardwire failures and controller errors. Air handling unit Performance Assessment Rules (APAR) is a fault detection tool that uses a set of expert rules derived from mass and energy balances to detect faults in air handling units. APAR is computationally simple enough that it can be embedded in commercial building automation and control systems and relies only upon sensor data and control signals that are commonly available in these systems. Although APAR has many advantages over other methods, for example no training data required and easy to implement commercially, most of the time it is unable to provide the diagnosis of the faults. For instance, a fault on temperature sensor could be fixed bias, drifting bias, inappropriate location, complete failure. Also a fault in mixing box can be return and outdoor damper leak or stuck. In addition, when multiple rules are satisfied the list of faults increases. There is no proper way to have the correct diagnosis for rule based fault detection system. To overcome this limitation we proposed Bayesian Belief Network (BBN) as a diagnostic tool. BBN can be used to simulate diagnostic thinking of FDD experts through a probabilistic way. In this study we developed a new way to detect and diagnose faults in AHU through combining APAR rules and Bayesian Belief network. Bayesian Belief Network is used as a decision support tool for rule based expert system. BBN is highly capable to prioritize faults when multiple rules are satisfied simultaneously. Also it can get information from previous AHU operating conditions and maintenance records to provide proper diagnosis. The proposed model is validated with real time measured data of a campus building at University of Texas at San Antonio (UTSA).The results show that BBN is correctly able to prioritize faults which can be verified by manual investigation.

Tax-exempt bonds and sponsored research.

PubMed

Ballard, Frederic L

2003-01-01

"Sponsored research," wherein a business corporation or the government pays a portion of the cost of research activities carried out by a university or hospital, is increasingly important both for state institutions and for Section 510(c)(3) organizations. Sponsored research arrangements that are not properly structured can jeopardize the status of tax-exempt bonds issued to finance the facility at which the sponsored research occurs. While these rules have been difficult to apply in practice, properly structured agreements can provide funding for research without undue risk. This Article discusses the multiple pieces of guidance put forth by the Internal Revenue Service to clarify the many issues and tiers of analysis necessary to ensure a properly-structured sponsored research agreement.

A Guide to the Changing Court Rulings on Union Security in the Public Sector: A Union Perspective.

ERIC Educational Resources Information Center

Darko, Richard J.; Knapp, Janet C.

1985-01-01

The Supreme Court in "Ellis vs. Brotherhood of Railway, Airline and Steamship Clerks" has provided a systematic process for determining what constitutes union expenses properly charged to objecting nonmembers. (MLF)

40 CFR Appendix II to Part 92 - Interpretive Ruling for § 92.705-Remedial Plans

Code of Federal Regulations, 2010 CFR

2010-07-01

... nonconformity of any such vehicles or engines. The plan shall provide that the manufacturer will remedy, at the manufacturer's expense, all properly maintained and used vehicles which experienced the nonconformity during...

48 CFR 6302.14 - Amendments of pleadings or record (Rule 14).

Code of Federal Regulations, 2010 CFR

2010-10-01

... answer. The application for such an order suspends the time for responsive pleading. The Board may, in... upon conditions just to both parties. (b) Record. When an issue within the proper scope of the appeal...

78 FR 68052 - Gregory Swecker, Beverly Swecker; Notice of Petition for Enforcement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... section 210(h) of the Public Utility Regulatory Policies Act of 1978 (PURPA), 16 U.S.C. 824 and Rules 385... enforcement action against Midland Power Cooperative to ensure that PURPA regulations are properly and...

Increasing patient knowledge on the proper usage of a PCA machine with the use of a post-operative instructional card.

PubMed

Shovel, Louisa; Max, Bryan; Correll, Darin J

2016-01-01

The purpose of this study was to see if an instructional card, attached to the PCA machine following total hip arthroplasty describing proper use of the device, would positively affect subjects' understanding of device usage, pain scores, pain medication consumption and satisfaction. Eighty adults undergoing total hip replacements who had been prescribed PCA were randomized into two study groups. Forty participants received the standard post-operative instruction on PCA device usage at our institution. The other 40 participants received the standard of care in addition to being given a typed instructional card immediately post-operatively, describing proper PCA device use. This card was attached to the PCA device during their recovery period. On post-operative day one, each patient completed a questionnaire on PCA usage, pain scores and satisfaction scores. The pain scores in the Instructional Card group were significantly lower than the Control group (p = 0.024). Subjects' understanding of PCA usage was also improved in the Instructional Card group for six of the seven questions asked. The findings from this study strongly support that postoperative patient information on proper PCA use by means of an instructional card improves pain control and hence the overall recovery for patients undergoing surgery. In addition, through improved understanding it adds an important safety feature in that patients and potentially their family members and/or friends may refrain from PCA-by-proxy. This article demonstrates that the simple intervention of adding an instructional card to a PCA machine is an effective method to improve patients' knowledge as well as pain control and potentially increase the safety of the device use.

Evaluation of decision rules for identifying low bone density in postmenopausal African-American women.

PubMed Central

Wallace, Lorraine Silver; Ballard, Joyce E.; Holiday, David; Turner, Lori W.; Keenum, Amy J.; Pearman, Cynthia M.

2004-01-01

OBJECTIVE: While African-American women tend to have greater bone mineral density (BMD) than caucasian women, they are still at risk of developing osteoporosis later in life. Clinical decision rules (i.e., algorithms) have been developed to assist clinicians identify women at greatest risk of low BMD. However, such tools have only been validated in caucasian and Asian populations. Accordingly, the objective of this study was to compare the performance of five clinical decision rules in identifying postmenopausal African-American women at greatest risk for low femoral BMD. METHODOLOGY: One hundred-seventy-four (n=174) postmenopausal African-American women completed a valid and reliable oral questionnaire to assess lifestyle characteristics, and completed height and weight measures. BMD at the femoral neck was measured via dual energy x-ray absorptiometry (DXA). We calculated sensitivity, specificity, positive predictive value, and negative predictive value for identifying African-American women with low BMD (T-Score < or = -2.0 SD) using five clinical decision rules: Age, Body Size, No Estrogen (ABONE), Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Self-Assessment Tool (OST), Simple Calculated Osteoporosis Risk Estimation (SCORE), and body weight less than 70 kg. RESULTS: Approximately 30% of African-American women had low BMD, half of whom had osteoporosis (BMD T-Score < or = -2.5 SD). Sensitivity for identifying women with a low BMD (T-Score < or = -2.0 SD) ranged from 65.57-83.61%, while specificity ranged from 53.85-78.85%. Positive predictive values ranged from 80.95-87.91%, while negative predictive values ranged from 48.44-58.33%. CONCLUSION: Our data suggest that the clinical decision rules analyzed in this study have some usefulness for identifying postmenopausal African-American women with low BMD. However, there is a need to establish cut-points for these clinical decision rules in a larger, more diverse sample of African-American women. PMID:15040510

Are medical students assigning proper global assessment of functioning scores?

PubMed

Warsi, Mustafa K; Sattar, S Pirzada; Din, Amad U; Petty, Frederick; Padala, Prasad R

2007-01-01

This article seeks to determine whether medical students can estimate the appropriate score for the Global Assessment of Functioning (GAF) compared with psychiatry residents and staff psychiatrists. The authors hypothesized that medical students' estimations of GAF scores for patients in clinical vignettes would differ from those assessed by the psychiatry residents and staff psychiatrists. The authors designed a cross-sectional confidential survey of medical students, psychiatry residents, and staff psychiatrists. Consenting participants were asked to provide demographic information and then complete the accompanying questionnaire after reading two vignettes. One of the vignettes described a depressed patient and the other a psychotic patient. The subjects were asked to estimate the GAF scores for the patients in both vignettes. Then the subjects were given the GAF scoring guide to review and were asked to re-assess their initial GAF scores for the patients in the vignettes. Medical students assigned much higher GAF scores for the patient in the vignette with less severe symptoms than the psychiatry residents and staff psychiatrists. The GAF scores of all three groups for the patient in the vignette with more severe symptoms were comparable. The ability of medical students to assign proper GAF scores needs to be studied further. Our study suggests that current 1-month rotations in psychiatry, without specific training on assigning GAF scores, may not provide medical students with enough information to assess GAF scores accurately. This might need to be addressed in psychiatry clerkships.

78 FR 10203 - Notice of Final Supplementary Rules for Public Lands in Colorado: Public Lands Administered by...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

..., or state, local, or tribal governments or communities. They do not create a serious inconsistency or... game during the proper season with appropriate firearms, as defined by the Colorado Parks and Wildlife...

SPARC GENERATED CHEMICAL PROPERTIES DATABASE FOR USE IN NATIONAL RISK ASSESSMENTS

EPA Science Inventory

The SPARC (Sparc Performs Automated Reasoning in Chemistry) Model was used to provide temperature dependent algorithms used to estimate chemical properties for approximately 200 chemicals of interest to the promulgation of the Hazardous Waste Identification Rule (HWIR) . Proper...

Synthesis of Polysyllabic Sequences of Thai Tones Using a Generative Model of Fundamental Frequency Contours

NASA Astrophysics Data System (ADS)

Seresangtakul, Pusadee; Takara, Tomio

In this paper, the distinctive tones of Thai in running speech are studied. We present rules to synthesize F0 contours of Thai tones in running speech by using the generative model of F0 contours. Along with our method, the pitch contours of Thai polysyllabic words, both disyllabic and trisyllabic words, were analyzed. The coarticulation effect of Thai tones in running speech were found. Based on the analysis of the polysyllabic words using this model, rules are derived and applied to synthesize Thai polysyllabic tone sequences. We performed listening tests to evaluate intelligibility of the rules for Thai tones generation. The average intelligibility scores became 98.8%, and 96.6% for disyllabic and trisyllabic words, respectively. From these result, the rule of the tones' generation was shown to be effective. Furthermore, we constructed the connecting rules to synthesize suprasegmental F0 contours using the trisyllable training rules' parameters. The parameters of the first, the third, and the second syllables were selected and assigned to the initial, the ending, and the remaining syllables in a sentence, respectively. Even such a simple rule, the synthesized phrases/senetences were completely identified in listening tests. The MOSs (Mean Opinion Score) was 3.50 while the original and analysis/synthesis samples were 4.82 and 3.59, respectively.

[Usefulness of clinical prediction rules for ruling out deep vein thrombosis in a hospital emergency department].

PubMed

Rosa-Jiménez, Francisco; Rosa-Jiménez, Ascensión; Lozano-Rodríguez, Aquiles; Santoro-Martínez, María Del Carmen; Duro-López, María Del Carmen; Carreras-Álvarez de Cienfuegos, Amelia

2015-01-01

To compare the efficacy of the most familiar clinical prediction rules in combination with D-dimer testing to rule out a diagnosis of deep vein thrombosis (DVT) in a hospital emergency department. Retrospective cross-sectional analysis of the case records of all patients attending a hospital emergency department with suspected lower-limb DVT between 1998 and 2002. Ten clinical prediction scores were calculated and D-dimer levels were available for all patients. The gold standard was ultrasound diagnosis of DVT by an independent radiologist who was blinded to clinical records. For each prediction rule, we analyzed the effectiveness of the prediction strategy defined by "low clinical probability and negative D-dimer level" against the ultrasound diagnosis. A total of 861 case records were reviewed and 577 cases were selected; the mean (SD) age was 66.7 (14.2) years. DVT was diagnosed in 145 patients (25.1%). Only the Wells clinical prediction rule and 4 other models had a false negative rate under 2%. The Wells criteria and the score published by Johanning and colleagues identified higher percentages of cases (15.6% and 11.6%, respectively). This study shows that several clinical prediction rules can be safely used in the emergency department, although none of them have proven more effective than the Wells criteria.

Ruling out coronary artery disease in primary care: development and validation of a simple prediction rule.

PubMed

Bösner, Stefan; Haasenritter, Jörg; Becker, Annette; Karatolios, Konstantinos; Vaucher, Paul; Gencer, Baris; Herzig, Lilli; Heinzel-Gutenbrunner, Monika; Schaefer, Juergen R; Abu Hani, Maren; Keller, Heidi; Sönnichsen, Andreas C; Baum, Erika; Donner-Banzhoff, Norbert

2010-09-07

Chest pain can be caused by various conditions, with life-threatening cardiac disease being of greatest concern. Prediction scores to rule out coronary artery disease have been developed for use in emergency settings. We developed and validated a simple prediction rule for use in primary care. We conducted a cross-sectional diagnostic study in 74 primary care practices in Germany. Primary care physicians recruited all consecutive patients who presented with chest pain (n = 1249) and recorded symptoms and findings for each patient (derivation cohort). An independent expert panel reviewed follow-up data obtained at six weeks and six months on symptoms, investigations, hospital admissions and medications to determine the presence or absence of coronary artery disease. Adjusted odds ratios of relevant variables were used to develop a prediction rule. We calculated measures of diagnostic accuracy for different cut-off values for the prediction scores using data derived from another prospective primary care study (validation cohort). The prediction rule contained five determinants (age/sex, known vascular disease, patient assumes pain is of cardiac origin, pain is worse during exercise, and pain is not reproducible by palpation), with the score ranging from 0 to 5 points. The area under the curve (receiver operating characteristic curve) was 0.87 (95% confidence interval [CI] 0.83-0.91) for the derivation cohort and 0.90 (95% CI 0.87-0.93) for the validation cohort. The best overall discrimination was with a cut-off value of 3 (positive result 3-5 points; negative result

Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule.

PubMed

Leroy, S; Marc, E; Adamsbaum, C; Gendrel, D; Bréart, G; Chalumeau, M

2006-03-01

To test the reproducibility of a highly sensitive clinical decision rule proposed to predict vesicoureteral reflux (VUR) after a first febrile urinary tract infection in children. This rule combines clinical (family history of uropathology, male gender, young age), biological (raised C reactive protein), and radiological (urinary tract dilation on renal ultrasound) predictors in a score, and provides 100% sensitivity. A retrospective hospital based cohort study included all children, 1 month to 4 years old, with a first febrile urinary tract infection. The sensitivities and specificities of the rule at the two previously proposed score thresholds (< or =0 and < or =5) to predict respectively, all-grade or grade > or =3 VUR, were calculated. A total of 149 children were included. VUR prevalence was 25%. The rule yielded 100% sensitivity and 3% specificity for all-grade VUR, and 93% sensitivity and 13% specificity for grade > or =3 VUR. Some methodological weaknesses explain this lack of reproducibility. The reproducibility of the previously proposed decision rule was poor and its potential contribution to clinical management of children with febrile urinary tract infection seems to be modest.

Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule

PubMed Central

Leroy, S; Marc, E; Adamsbaum, C; Gendrel, D; Bréart, G; Chalumeau, M

2006-01-01

Aims To test the reproducibility of a highly sensitive clinical decision rule proposed to predict vesicoureteral reflux (VUR) after a first febrile urinary tract infection in children. This rule combines clinical (family history of uropathology, male gender, young age), biological (raised C reactive protein), and radiological (urinary tract dilation on renal ultrasound) predictors in a score, and provides 100% sensitivity. Methods A retrospective hospital based cohort study included all children, 1 month to 4 years old, with a first febrile urinary tract infection. The sensitivities and specificities of the rule at the two previously proposed score thresholds (⩽0 and ⩽5) to predict respectively, all‐grade or grade ⩾3 VUR, were calculated. Results A total of 149 children were included. VUR prevalence was 25%. The rule yielded 100% sensitivity and 3% specificity for all‐grade VUR, and 93% sensitivity and 13% specificity for grade ⩾3 VUR. Some methodological weaknesses explain this lack of reproducibility. Conclusions The reproducibility of the previously proposed decision rule was poor and its potential contribution to clinical management of children with febrile urinary tract infection seems to be modest. PMID:15890693

77 FR 38729 - Alternate Tonnage Threshold for Oil Spill Response Vessels

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

...The Coast Guard is establishing an alternate size threshold based on the measurement system established under the International Convention on Tonnage Measurement of Ships, 1969, for oil spill response vessels, which are properly certificated under 46 CFR chapter I, subchapter L. The present size threshold of 500 gross register tons is based on the U.S. regulatory measurement system. This final rule provides an alternative for owners and operators of offshore supply vessels that may result in an increase in oil spill response capacity and capability. This final rule adopts, without change, the interim rule amending 46 CFR part 126 published in the Federal Register on Monday, December 12, 2011.

Understanding Culture and Influencing Change

DTIC Science & Technology

2010-03-01

difference to significantly change the society from a collectivist to individualist culture .42 Pakistan scores fourteen which indicates a strongly...score lower than fifty indicating a more collectivist society. This helps the strategic leader to appreciate the importance class and culture play on...Pakistan which possess strong uncertainty avoidance scores (70) and low individualistic scores (14) - and are collectivists - rules and laws are

76 FR 75435 - Fatigue Tolerance Evaluation of Metallic Structures

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-02

..., Regulations and Policy Group, Rotorcraft Directorate, ASW-111, Federal Aviation Administration, 2601 Meacham... designed and manufactured, performs properly, and meets the regulations and minimum standards prescribed... amended rule requires a specific result (that is, inspection, retirement times, or equivalent means to...

Technical Assistance Document for Complying with the Toxicity Characteristics Rule and Implementing the Toxicity Characteristic Leaching Procedure

EPA Pesticide Factsheets

The goal of this document is to assist the regulated community to make proper utilization of the Toxicity Characteristic Leaching Procedure (TCLP) to demonstrate compliance with the Toxicity Characteristic (TC) and Land Ban Regulations.

Lead and Copper Tap Sample Site Plan Instructions

EPA Pesticide Factsheets

This document may be used by public water systems in Wyoming and on EPA R8 Tribal Lands as a guide for how to properly complete their lead and copper tap sample site plans to comply with the Lead and Copper Rule.

Analysis of the iteratively regularized Gauss-Newton method under a heuristic rule

NASA Astrophysics Data System (ADS)

Jin, Qinian; Wang, Wei

2018-03-01

The iteratively regularized Gauss-Newton method is one of the most prominent regularization methods for solving nonlinear ill-posed inverse problems when the data is corrupted by noise. In order to produce a useful approximate solution, this iterative method should be terminated properly. The existing a priori and a posteriori stopping rules require accurate information on the noise level, which may not be available or reliable in practical applications. In this paper we propose a heuristic selection rule for this regularization method, which requires no information on the noise level. By imposing certain conditions on the noise, we derive a posteriori error estimates on the approximate solutions under various source conditions. Furthermore, we establish a convergence result without using any source condition. Numerical results are presented to illustrate the performance of our heuristic selection rule.

Towards Better Computational Models of the Balance Scale Task: A Reply to Shultz and Takane

ERIC Educational Resources Information Center

van der Maas, Han L. J.; Quinlan, Philip T.; Jansen, Brenda R. J.

2007-01-01

In contrast to Shultz and Takane [Shultz, T.R., & Takane, Y. (2007). Rule following and rule use in the balance-scale task. "Cognition", in press, doi:10.1016/j.cognition.2006.12.004.] we do not accept that the traditional Rule Assessment Method (RAM) of scoring responses on the balance scale task has advantages over latent class analysis (LCA):…

Three CLIPS-based expert systems for solving engineering problems

NASA Technical Reports Server (NTRS)

Parkinson, W. J.; Luger, G. F.; Bretz, R. E.

1990-01-01

We have written three expert systems, using the CLIPS PC-based expert system shell. These three expert systems are rule based and are relatively small, with the largest containing slightly less than 200 rules. The first expert system is an expert assistant that was written to help users of the ASPEN computer code choose the proper thermodynamic package to use with their particular vapor-liquid equilibrium problem. The second expert system was designed to help petroleum engineers choose the proper enhanced oil recovery method to be used with a given reservoir. The effectiveness of each technique is highly dependent upon the reservoir conditions. The third expert system is a combination consultant and control system. This system was designed specifically for silicon carbide whisker growth. Silicon carbide whiskers are an extremely strong product used to make ceramic and metal composites. The manufacture of whiskers is a very complicated process. which to date. has defied a good mathematical model. The process was run by experts who had gained their expertise by trial and error. A system of rules was devised by these experts both for procedure setup and for the process control. In this paper we discuss the three problem areas of the design, development and evaluation of the CLIPS-based programs.

The MMPI Assistant: A Microcomputer Based Expert System to Assist in Interpreting MMPI Profiles

PubMed Central

Tanner, Barry A.

1989-01-01

The Assistant is an MS DOS program to aid clinical psychologists in interpreting the results of the Minnesota Multiphasic Personality Inventory (MMPI). Interpretive hypotheses are based on the professional literature and the author's experience. After scores are entered manually, the Assistant produces a hard copy which is intended for use by a psychologist knowledgeable about the MMPI. The rules for each hypothesis appear first on the monitor, and then in the printed output, followed by the patient's scores on the relevant scales, and narrative hypotheses for the scores. The data base includes hypotheses for 23 validity configurations, 45 two-point clinical codes, 10 high scoring single-point clinical scales, and 10 low scoring single-point clinical scales. The program can accelerate the production of test reports, while insuring that actuarial rules are not overlooked. It has been especially useful as a teaching tool with graduate students. The Assistant requires an IBM PC compatible with 128k available memory, DOS 2.x or higher, and a printer.

On the effects of adaptive reservoir operating rules in hydrological physically-based models

NASA Astrophysics Data System (ADS)

Giudici, Federico; Anghileri, Daniela; Castelletti, Andrea; Burlando, Paolo

2017-04-01

Recent years have seen a significant increase of the human influence on the natural systems both at the global and local scale. Accurately modeling the human component and its interaction with the natural environment is key to characterize the real system dynamics and anticipate future potential changes to the hydrological regimes. Modern distributed, physically-based hydrological models are able to describe hydrological processes with high level of detail and high spatiotemporal resolution. Yet, they lack in sophistication for the behavior component and human decisions are usually described by very simplistic rules, which might underperform in reproducing the catchment dynamics. In the case of water reservoir operators, these simplistic rules usually consist of target-level rule curves, which represent the average historical level trajectory. Whilst these rules can reasonably reproduce the average seasonal water volume shifts due to the reservoirs' operation, they cannot properly represent peculiar conditions, which influence the actual reservoirs' operation, e.g., variations in energy price or water demand, dry or wet meteorological conditions. Moreover, target-level rule curves are not suitable to explore the water system response to climate and socio economic changing contexts, because they assume a business-as-usual operation. In this work, we quantitatively assess how the inclusion of adaptive reservoirs' operating rules into physically-based hydrological models contribute to the proper representation of the hydrological regime at the catchment scale. In particular, we contrast target-level rule curves and detailed optimization-based behavioral models. We, first, perform the comparison on past observational records, showing that target-level rule curves underperform in representing the hydrological regime over multiple time scales (e.g., weekly, seasonal, inter-annual). Then, we compare how future hydrological changes are affected by the two modeling approaches by considering different future scenarios comprising climate change projections of precipitation and temperature and projections of electricity prices. We perform this comparative assessment on the real-world water system of Lake Como catchment in the Italian Alps, which is characterized by the massive presence of artificial hydropower reservoirs heavily altering the natural hydrological regime. The results show how different behavioral model approaches affect the system representation in terms of hydropower performance, reservoirs dynamics and hydrological regime under different future scenarios.

37 CFR 262.7 - Verification of royalty payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Designated Agent have agreed as to proper verification methods. (b) Frequency of verification. A Copyright Owner or a Performer may conduct a single audit of the Designated Agent upon reasonable notice and... COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES RATES AND TERMS FOR CERTAIN ELIGIBLE...

A Good Suit Beats a Good Idea.

ERIC Educational Resources Information Center

Machiavelli, Nick

1992-01-01

Inspired by Niccolo Machiavelli, this column offers beleaguered school executives advice on looking good, dressing well, losing weight, beating the proper enemy, and saying nothing. Administrators who follow these simple rules should have an easier life, jealous colleagues, well-tended gardens, and respectful board members. (MLH)

Recognizing and Dealing with Dangerous Gases.

ERIC Educational Resources Information Center

Bove, Robert A.

1978-01-01

When handling hazardous gases, it is necessary to know their properties, precautions that can be taken to protect workers, and proper first aid. This article gives everyday rules for handling gas cylinders, and a brief first aid guide for 12 common toxic gases and vapors. (BB)

47 CFR 1.903 - Authorization required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Applications and Proceedings Scope and Authority § 1.903 Authorization required. (a) General rule. Stations in... period specified in the authorization. Authorizations may be granted upon proper application, provided... operate mobile or fixed stations in the Wireless Radio Services, except for certain stations in the Rural...

76 FR 52533 - Personnel Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... financial impact on agencies. Another commenter stated that the OPM's Enterprise Human Resource Integration..., statistical analysis, and raw data used to justify the rule and the human capital cost increase to implement... activities that are properly considered functions of agency human resources offices and thus ensure that an...

Coronary artery calcification score by multislice computed tomography predicts the outcome of dobutamine cardiovascular magnetic resonance imaging.

PubMed

Janssen, Caroline H C; Kuijpers, Dirkjan; Vliegenthart, Rozemarijn; Overbosch, Jelle; van Dijkman, Paul R M; Zijlstra, Felix; Oudkerk, Matthijs

2005-06-01

The aim of this study was to determine whether a coronary artery calcium (CAC) score of less than 11 can reliably rule out myocardial ischemia detected by dobutamine cardiovascular magnetic resonance imaging (CMR) in patients suspected of having myocardial ischemia. In 114 of 136 consecutive patients clinically suspected of myocardial ischemia with an inconclusive diagnosis of myocardial ischemia, dobutamine CMR was performed and the CAC score was determined. The CAC score was obtained by 16-row multidetector compued tomography (MDCT) and was calculated according to the method of Agatston. The CAC score and the results of the dobutamine CMR were correlated and the positive predictive value (PPV) and the negative predictive value (NPV) of the CAC score for dobutamine CMR were calculated. A total of 114 (87%) of the patients were eligible for this study. There was a significant correlation between the CAC score and dobutamine CMR (p<0.001). Patients with a CAC score of less than 11 showed no signs of inducible ischemia during dobutamine CMR. For a CAC score of less than 101, the NPV and the PPV of the CAC score for the outcome of dobutamine CMR were, respectively, 0.96 and 0.29. In patients with an inconclusive diagnosis of myocardial ischemia a MDCT CAC score of less than 11 reliably rules out myocardial ischemia detected by dobutamine CMR.

Validity Semantics in Educational and Psychological Assessment

ERIC Educational Resources Information Center

Hathcoat, John D.

2013-01-01

The semantics, or meaning, of validity is a fluid concept in educational and psychological testing. Contemporary controversies surrounding this concept appear to stem from the proper location of validity. Under one view, validity is a property of score-based inferences and entailed uses of test scores. This view is challenged by the…

Military Strategists are from Mars, Rule of Law Theorists are from Venus: Why Imposition of the Rule of Law Requires a Goldwater-Nichols Modeled Interagency Reform

DTIC Science & Technology

2008-04-01

demonstrates 2 Joseph J. Collins, Planning Lessons from Iraq and Afghanistan, JOINT FORCES Q., 2d Quarter 2006, at 10, 11. U.S. conventional military power...diplomatic, informational, military, and economic efforts." Id. It lists eight "trends that will affect ground force operations," to include...this definition is capable of producing a "cultural commitment’"’ by the host-nation if properly pursued from the planning stages of an intervention

Evaluation of Potential Continuation Rules for Mepolizumab Treatment of Severe Eosinophilic Asthma.

PubMed

Gunsoy, Necdet B; Cockle, Sarah M; Yancey, Steven W; Keene, Oliver N; Bradford, Eric S; Albers, Frank C; Pavord, Ian D

Mepolizumab significantly reduces exacerbations in patients with severe eosinophilic asthma. The early identification of patients likely to receive long-term benefit from treatment could ensure effective resource allocation. To assess potential continuation rules for mepolizumab in addition to initiation criteria defined as 2 or more exacerbations in the previous year and blood eosinophil counts of 150 cells/μL or more at initiation or 300 cells/μL or more in the previous year. This post hoc analysis included data from 2 randomized, double-blind, placebo-controlled studies (NCT01000506 and NCT01691521) of mepolizumab in patients with severe eosinophilic asthma (N = 1,192). Rules based on blood eosinophils, physician-rated response to treatment, FEV 1 , Asthma Control Questionnaire (ACQ-5) score, and exacerbation reduction were assessed at week 16. To assess these rules, 2 key metrics accounting for the effects observed in the placebo arm were developed. Patients not meeting continuation rules based on physician-rated response, FEV 1 , and the ACQ-5 score still derived long-term benefit from mepolizumab. Nearly all patients failing to reduce blood eosinophils had counts of 150 cells/μL or less at baseline. For exacerbations, assessment after 16 weeks was potentially premature for predicting future exacerbations. There was no evidence of a reliable physician-rated response, ACQ-5 score, or lung function-based continuation rule. The added value of changes in blood eosinophils at week 16 over baseline was marginal. Initiation criteria for mepolizumab treatment provide the best method for assessing patient benefit from mepolizumab treatment, and treatment continuation should be reviewed on the basis of a predefined reduction in long-term exacerbation frequency and/or oral corticosteroid dose. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Merit-Based Incentive Payment System: Meaningful Changes in the Final Rule Brings Cautious Optimism.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Calodney, Aaron K; Hirsch, Joshua A

2017-01-01

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category. The proposed rule also changed the name of MU to Advancing Care Information, or ACI. ACI contributes to 25% of composite score of the four programs, PQRS contributes 50% of the composite score, while VBP system, which deals with resource use or cost, contributes to 10% of the composite score. The newest category, Improvement Activities or IA, contributes 15% to the composite score. The proposed rule also created what it called a design incentive that drives movement to delivery system reform principles with the inclusion of Advanced Alternative Payment Models (APMs).Following the release of the proposed rule, the medical community, as well as Congress, provided substantial input to Centers for Medicare and Medicaid Services (CMS),expressing their concern. American Society of Interventional Pain Physicians (ASIPP) focused on 3 important aspects: delay the implementation, provide a 3-month performance period, and provide ability to submit meaningful quality measures in a timely and economic manner. The final rule accepted many of the comments from various organizations, including several of those specifically emphasized by ASIPP, with acceptance of 3-month reporting period, as well as the ability to submit non-MIPS measures to improve real quality and make the system meaningful. CMS also provided a mechanism for physicians to avoid penalties for non-reporting with reporting of just a single patient. In summary, CMS has provided substantial flexibility with mechanisms to avoid penalties, reporting for 90 continuous days, increasing the low volume threshold, changing the reporting burden and data thresholds and, finally, coordination between performance categories. The final rule has made MIPS more meaningful with bonuses for exceptional performance, the ability to report for 90 days, and to report on 50% of the patients in 2017 and 60% of the patients in 2018. The final rule also reduced the quality measures to 6, including only one outcome or high priority measure with elimination of cross cutting measure requirement. In addition, the final rule reduced the burden of ACI, improved the coordination of performance, reduced improvement activities burden from 60 points to 40 points, and finally improved coordination between performance categories. Multiple concerns remain regarding the reduction in scoring for quality improvement in future years, increase in proportion of MIPS scoring for resource use utilizing flawed, claims based methodology and the continuation of the disproportionate importance of ACI, an expensive program that can be onerous for providers which in many ways has not lived up to its promise. Key words: Medicare Access and CHIP Reauthorization Act of 2015, merit-based incentive payment system, quality performance measures, resource use, improvement activities, advancing care information performance category.

Research directed toward improved echelles for the ultraviolet

NASA Technical Reports Server (NTRS)

1977-01-01

Research was undertaken to demonstrate that improved efficiencies for low frequency gratings are obtainable with the careful application of present technology. The motivation for the study was the desire to be assured that the grating-efficiency design goals for potential Space Telescope spectrographs can be achieved. The work was organized to compare gratings made with changes in the three specific parameters: the ruling tool profile, the coating material, and the lubricants used during the ruling process. A series of coatings and test gratings were fabricated and were examined for surface smoothness with a Nomarski Differential Interference Microscope and an electron microscope. Photomicrographs were obtained to show the difference in smoothness of the various coatings and rulings. Efficiency measurements were made for those test rulings that showed good groove characteristics: smoothness, proper ruling depth, and absence of defects. The intuitive feeling that higher grating efficiency should be correlated with the degree of smoothness of both the coating and the grating is supported by the results.

Impact of Eliminating Anchor Items Flagged from Statistical Criteria on Test Score Classifications in Common Item Equating

ERIC Educational Resources Information Center

Karkee, Thakur; Choi, Seung

2005-01-01

Proper maintenance of a scale established in the baseline year would assure the accurate estimation of growth in subsequent years. Scale maintenance is especially important when the state performance standards must be preserved for future administrations. To ensure proper maintenance of a scale, the selection of anchor items and evaluation of…

Automated implementation of rule-based expert systems with neural networks for time-critical applications

NASA Technical Reports Server (NTRS)

Ramamoorthy, P. A.; Huang, Song; Govind, Girish

1991-01-01

In fault diagnosis, control and real-time monitoring, both timing and accuracy are critical for operators or machines to reach proper solutions or appropriate actions. Expert systems are becoming more popular in the manufacturing community for dealing with such problems. In recent years, neural networks have revived and their applications have spread to many areas of science and engineering. A method of using neural networks to implement rule-based expert systems for time-critical applications is discussed here. This method can convert a given rule-based system into a neural network with fixed weights and thresholds. The rules governing the translation are presented along with some examples. We also present the results of automated machine implementation of such networks from the given rule-base. This significantly simplifies the translation process to neural network expert systems from conventional rule-based systems. Results comparing the performance of the proposed approach based on neural networks vs. the classical approach are given. The possibility of very large scale integration (VLSI) realization of such neural network expert systems is also discussed.

A rule-based smart automated fertilization and irrigation systems

NASA Astrophysics Data System (ADS)

Yousif, Musab El-Rashid; Ghafar, Khairuddin; Zahari, Rahimi; Lim, Tiong Hoo

2018-04-01

Smart automation in industries has become very important as it can improve the reliability and efficiency of the systems. The use of smart technologies in agriculture have increased over the year to ensure and control the production of crop and address food security. However, it is important to use proper irrigation systems avoid water wastage and overfeeding of the plant. In this paper, a Smart Rule-based Automated Fertilization and Irrigation System is proposed and evaluated. We propose a rule based decision making algorithm to monitor and control the food supply to the plant and the soil quality. A build-in alert system is also used to update the farmer using a text message. The system is developed and evaluated using a real hardware.

78 FR 25324 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-30

... rules governing offers and sales of securities made outside the United States without registration under... 5 of the Securities Act applies to offers and sales of securities outside of the United States...) Whether this collection of information is necessary for the proper performance of the functions of the...

5 CFR 1651.8 - Participant's estate.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Participant's estate. If the account is to be paid to the duly appointed executor or administrator of the participant's estate under § 1651.2(a)(5), the following rules apply: (a) Appointment by court. The executor... executor or administrator. Documentation which demonstrates that the person is properly authorized under...

Public Law 99-519: Title II--Asbestos Hazard Emergency Response.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC.

The Environmental Protection Agency's rule on local educational agency inspection for, and notification of, the presence of friable asbestos-containing material in school buildings included neither standards for the proper identification of asbestos-containing material and appropriate response actions with respect to friable asbestos-containing…

49 CFR 236.526 - Roadway element not functioning properly.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Rules and Instructions; Roadway § 236.526 Roadway..., train control or cab signal system is not functioning as intended, the signal associated with such...

49 CFR 236.526 - Roadway element not functioning properly.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Automatic Train Stop, Train Control and Cab Signal Systems Rules and Instructions; Roadway § 236.526 Roadway..., train control or cab signal system is not functioning as intended, the signal associated with such...

78 FR 40531 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing of a Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

... Exchange from allowing re-entry into the Program where the Exchange deems such re-entry as proper. CLP... its status as a CLP, such Member may re- apply for CLP status. Such application process shall occur at...

Development of a clinical prediction rule for risk stratification of recurrent venous thromboembolism in patients with cancer-associated venous thromboembolism.

PubMed

Louzada, Martha L; Carrier, Marc; Lazo-Langner, Alejandro; Dao, Vi; Kovacs, Michael J; Ramsay, Timothy O; Rodger, Marc A; Zhang, Jerry; Lee, Agnes Y Y; Meyer, Guy; Wells, Philip S

2012-07-24

Long-term low-molecular-weight heparin (LMWH) is the current standard for treatment of venous thromboembolism (VTE) in cancer patients. Whether treatment strategies should vary according to individual risk of VTE recurrence remains unknown. We performed a retrospective cohort study and a validation study in patients with cancer-associated VTE to derive a clinical prediction rule that stratifies VTE recurrence risk. The cohort study of 543 patients determined the model with the best classification performance included 4 independent predictors (sex, primary tumor site, stage, and prior VTE) with 100% sensitivity, a wide separation of recurrence rates, 98.1% negative predictive value, and a negative likelihood ratio of 0.16. In this model, the score sum ranged between -3 and 3 score points. Patients with a score ≤ 0 had low risk (≤ 4.5%) for recurrence and patients with a score >1 had a high risk (≥ 19%) for VTE recurrence. Subsequently, we applied and validated the rule in an independent set of 819 patients from 2 randomized, controlled trials comparing low-molecular-weight heparin to coumarin treatment in cancer patients. By identifying VTE recurrence risk in cancer patients with VTE, we may be able to tailor treatment, improving clinical outcomes while minimizing costs.

Amateur boxing in the last 59 years. Impact of rules changes on the type of verdicts recorded and implications on boxers' health.

PubMed

Bianco, Massimiliano; Loosemore, Mike; Daniele, Gianlorenzo; Palmieri, Vincenzo; Faina, Marcello; Zeppilli, Paolo

2013-05-01

Several changes have occurred in Olympic boxing (OB) in the last few decades, influencing the results in official competitions. The aim of this study was to assess how the evolution of rules changed the rate of the results that can influence boxers' health. From a web-research, the results of OB tournaments from 1952 to 2011 were reviewed (29,357 bouts). For each event, rate of knockout (KO), referee-stop contest (RSC), RSC-Head (RSCH), RSC-Injury (RSCI), RSC-Outclassed (RSCO), abandon, disqualification and points decisions were recorded. In our analysis we investigated the changes that occurred after the introduction of the standing-count rule (1964), mandatory head guard (1984), computerised scoring system (1992), RSCO (2000-2009) and modification of bout formula 3×3 min rounds (3×3, until 1997, 5×2 min rounds (5×2) until 1999, 4×2 min rounds (4×2) until 2008, 3×3 from 2009). The most important results were: (1) an RSCI rate increase (0.72-2.42%, p<0.03) after the standing-count rule; (2) a lower RSCI (0.60%, p<0.001) and higher RSCH (1.31-4.92%, p<0.001) and RSC (9.71-13.05%, p<0.03) rate with mandatory head guard; (3) a KO rate reduction (6.44-2.09%, p<0.001) with the computerised scoring system; (4) an RSC (13.15-5.91%, p<0.05) and RSCH (4.23-1.41%, p<0.001) rate reduction comparing 5×2-4×2 bouts. In the last six decades, along with rule changes in OB, a clear reduction of health challenging results was observed. In the near future, older rules will be adopted (no head guard and a manual scoring system). Continued medical surveillance is important to ensure that new rule changes do not result in poor medical outcomes for the boxers.

A Diffusion Model Explanation of the Worst Performance Rule for Reaction Time and IQ

ERIC Educational Resources Information Center

Ratcliff, Roger; Schmiedek, Florian; McKoon, Gail

2008-01-01

The worst performance rule for cognitive tasks [Coyle, T.R. (2003). IQ, the worst performance rule, and Spearman's law: A reanalysis and extension. "Intelligence," 31, 567-587] in which reaction time is measured is the result that IQ scores correlate better with longer (i.e., 0.7 and 0.9 quantile) reaction times than shorter (i.e., 0.1 and 0.3…

Rational identification of aggregation hotspots based on secondary structure and amino acid hydrophobicity.

PubMed

Matsui, Daisuke; Nakano, Shogo; Dadashipour, Mohammad; Asano, Yasuhisa

2017-08-25

Insolubility of proteins expressed in the Escherichia coli expression system hinders the progress of both basic and applied research. Insoluble proteins contain residues that decrease their solubility (aggregation hotspots). Mutating these hotspots to optimal amino acids is expected to improve protein solubility. To date, however, the identification of these hotspots has proven difficult. In this study, using a combination of approaches involving directed evolution and primary sequence analysis, we found two rules to help inductively identify hotspots: the α-helix rule, which focuses on the hydrophobicity of amino acids in the α-helix structure, and the hydropathy contradiction rule, which focuses on the difference in hydrophobicity relative to the corresponding amino acid in the consensus protein. By properly applying these two rules, we succeeded in improving the probability that expressed proteins would be soluble. Our methods should facilitate research on various insoluble proteins that were previously difficult to study due to their low solubility.

Interim rules for amending ERISA disclosure requirements for group health plans; approval of information collection requirements--DoL. Interim rules; approval of information collection requirements.

PubMed

1997-07-07

On April 8, 1997, the Department of Labor published interim final rules governing disclosure requirements for private sector group health plans (62 FR 16979). The rules implemented changes to made to certain provisions of the Employee Retirement Income Security Act of 1974 (ERISA), enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). In the April 8 publication, the Department submitted its revision of the currently approved collection regarding Summary Plan Description requirements under ERISA to the Office of Management and Budget (OMB) for emergency review under the Paperwork Reduction Act of 1965 (PRA 95). This document amends the April 8 Federal Register document to properly display the OMB control number, 1210-0039.

Derivation and Validation of a Clostridium difficile Infection Recurrence Prediction Rule in a National Cohort of Veterans.

PubMed

Reveles, Kelly R; Mortensen, Eric M; Koeller, Jim M; Lawson, Kenneth A; Pugh, Mary Jo V; Rumbellow, Sarah A; Argamany, Jacqueline R; Frei, Christopher R

2018-03-01

Prior studies have identified risk factors for recurrent Clostridium difficile infection (CDI), but few studies have integrated these factors into a clinical prediction rule that can aid clinical decision-making. The objectives of this study were to derive and validate a CDI recurrence prediction rule to identify patients at risk for first recurrence in a national cohort of veterans. Retrospective cohort study. Veterans Affairs Informatics and Computing Infrastructure. A total of 22,615 adult Veterans Health Administration beneficiaries with first-episode CDI between October 1, 2002, and September 30, 2014; of these patients, 7538 were assigned to the derivation cohort and 15,077 to the validation cohort. A 60-day CDI recurrence prediction rule was created in a derivation cohort using backward logistic regression. Those variables significant at p<0.01 were assigned an integer score proportional to the regression coefficient. The model was then validated in the derivation cohort and a separate validation cohort. Patients were then split into three risk categories, and rates of recurrence were described for each category. The CDI recurrence prediction rule included the following predictor variables with their respective point values: prior third- and fourth-generation cephalosporins (1 point), prior proton pump inhibitors (1 point), prior antidiarrheals (1 point), nonsevere CDI (2 points), and community-onset CDI (3 points). In the derivation cohort, the 60-day CDI recurrence risk for each score ranged from 7.5% (0 points) to 57.9% (8 points). The risk score was strongly correlated with recurrence (R 2  = 0.94). Patients were split into low-risk (0-2 points), medium-risk (3-5 points), and high-risk (6-8 points) classes and had the following recurrence rates: 8.9%, 20.2%, and 35.0%, respectively. Findings were similar in the validation cohort. Several CDI and patient-specific factors were independently associated with 60-day CDI recurrence risk. When integrated into a clinical prediction rule, higher risk scores and risk classes were strongly correlated with CDI recurrence. This clinical prediction rule can be used by providers to identify patients at high risk for CDI recurrence and help guide preventive strategy decisions, while accounting for clinical judgment. © 2018 Pharmacotherapy Publications, Inc.

Rule-governed behavior and behavioral anthropology

PubMed Central

Malott, Richard W.

1988-01-01

According to cultural materialism, cultural practices result from the materialistic outcomes of those practices, not from sociobiological, mentalistic, or mystical predispositions (e.g., Hindus worship cows because, in the long run, that worship results in more food, not less food). However, according to behavior analysis, such materialistic outcomes do not reinforce or punish the cultural practices, because such outcomes are too delayed, too improbable, or individually too small to directly reinforce or punish the cultural practices (e.g., the food increase is too delayed to reinforce the cow worship). Therefore, the molar, materialistic contingencies need the support of molecular, behavioral contingencies. And according to the present theory of rule-governed behavior, the statement of rules describing those molar, materialistic contingencies can establish the needed molecular contingencies. Given the proper behavioral history, such rule statements combine with noncompliance to produce a learned aversive condition (often labeled fear, anxiety, or guilt). The termination of this aversive condition reinforces compliance, just as its presentation punishes noncompliance (e.g., the termination of guilt reinforces the tending to a sick cow). In addition, supernatural rules often supplement these materialistic rules. Furthermore, the production of both materialistic and supernatural rules needs cultural designers who understand the molar, materialistic contingencies. PMID:22478012

Development of Open-Ended Problems for Measuring The Higher-Order-Thinking-Skills of High School Students on Global Warming Phenomenon

NASA Astrophysics Data System (ADS)

Fianti; Najwa, F. L.; Linuwih, S.

2017-04-01

Higher-order-thinking-skills can not be developed directly, except by training which is employing open-ended problems for measuring and developing critics, creativeness, and problem-solving thinking-skills of students. This study is a research and development producing open-ended problems. The purpose of this study is to measure the properness and effectiveness of the developed product and to observe the profile of higher-order-thinking-skills of students on global warming phenomenon. The result of properness test of open-ended problems according to the experts is 92,59% on the first stage and 97,53% on the second stage, so we can assume that the product isvery proper. The result of effectiveness test shows the coefficient of correlation between student’s midterm test scores and open-ended questions is 0,634 which is in the category of strong. Higher-order-thinking-skills of SMA Negeri 1 Salatiga students is in the category of good with the average achievement scores 61,28.

Research and development for Onboard Navigation (ONAV) ground based expert/trainer system: ONAV entry expert system code

NASA Technical Reports Server (NTRS)

Bochsler, Daniel C.

1988-01-01

A complete listing is given of the expert system rules for the Entry phase of the Onboard Navigation (ONAV) Ground Based Expert Trainer System for aircraft/space shuttle navigation. These source listings appear in the same format as utilized and required by the C Language Integrated Production System (CLIPS) expert system shell which is the basis for the ONAV entry system. A schematic overview is given of how the rules are organized. These groups result from a partitioning of the rules according to the overall function which a given set of rules performs. This partitioning was established and maintained according to that established in the knowledge specification document. In addition, four other groups of rules are specified. The four groups (control flow, operator inputs, output management, and data tables) perform functions that affect all the other functional rule groups. As the name implies, control flow ensures that the rule groups are executed in the order required for proper operation; operator input rules control the introduction into the CLIPS fact base of various kinds of data required by the expert system; output management rules control the updating of the ONAV expert system user display screen during execution of the system; and data tables are static information utilized by many different rule sets gathered in one convenient place.

Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI-18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview).

PubMed

Grassi, Luigi; Caruso, Rosangela; Mitchell, Alex J; Sabato, Silvana; Nanni, Maria Giulia

2018-06-01

Given the adverse consequences of psychiatric and psychosocial morbidity on the quality of life for patients with cancer, prompt detection of psychological symptoms is mandatory. The authors examined the properties and accuracy of the Brief Symptom Inventory (the 53-item version [BSI] and the 18-item version [BSI-18]) for the detection of psychiatric morbidity compared with the World Health Organization Composite International Diagnostic Interview (CIDI) for International Classification of Diseases-10th Revision psychiatric diagnoses. A convenience sample of 498 patients with newly diagnosed cancer who were recruited in cancer outpatient services participated in the CIDI interview and in BSI and BSI-18 assessments. The prevalence of psychiatric morbidity was 39.75%. When participants were classified as cases using the BSI standard case rule, agreement with the CIDI was potentially acceptable (sensitivity, 72.7%; specificity, 88.7%). In contrast, the accuracy of the BSI-18 in identifying cases was poor according to the standard case rule, with very low sensitivity (29.3%) (misclassification rate, 28.7%). By using a first alternative case-rule system (a BSI-18 global severity index [GSI] T-score ≥57), sensitivity marginally improved (45%), whereas a second alternative case-rule system (a GSI T-score ≥50) significantly increased sensitivity (77.3%). In receiver operating characteristic curve analysis, a further cutoff GSI T-score ≥48 exhibited good discrimination levels (sensitivity, 82.3%; specificity, 72.4%). There were some differences in GSI cutoff T-scores according to the International Classification of Diseases-10th Revision diagnosis and sex. The BSI appeared to have acceptable diagnostic accuracy compared with a standardized psychiatric interview. For the BSI-18, it is mandatory to use alternative case-rule systems, to identify patients with psychiatric morbidity. Cancer 2018;124:2415-26. © 2018 American Cancer Society. © 2018 American Cancer Society.

The Role of Scoring Systems and Urine Dipstick in Prediction of Rhabdomyolysis-induced Acute Kidney Injury: a Systematic Review.

PubMed

Safari, Saeed; Yousefifard, Mahmoud; Hashemi, Behrooz; Baratloo, Alireza; Forouzanfar, Mohammad Mehdi; Rahmati, Farhad; Motamedi, Maryam; Najafi, Iraj

2016-05-01

During the past decade, using serum biomarkers and clinical decision rules for early prediction of rhabdomyolysis-induced acute kidney injury (AKI) has received much attention from researchers. This study aimed to broadly review the value of scoring systems and urine dipstick in prediction of rhabdomyolysis-induced AKI. The study was designed based on the guidelines of the Meta-analysis of Observational Studies in Epidemiology statement. Search was done in electronic databases of MEDLINE, EMBASE, Cochrane Library, Scopus, and Google Scholar by 2 independent reviewers. Studies evaluating AKI risk factors in rhabdomyolysis patients with the aim of developing a scoring model as well as those assessing the role of urine dipstick in these patients were included. Of the 5997 articles found, 143 were potentially relevant studies. After studying their full texts, 6 articles were entered into the systematic review. Two studies had developed or validated scoring systems of the "rule of thumb," and the AKI index, and the Mangled Extremity Severity Score. Four studies were on the predictive value of urine dipstick in risk prediction of rhabdomyolysis-induced AKI, with favorable results. The findings of this systematic review showed that based on the available resources, using the prediction rules and urine dipstick could be considered as valuable screening tools for detection of patients at risk for AKI following rhabdomyolysis. Yet, the external validity of the mentioned tools should be assessed before their general application in routine practice.

Correlational correction to plasmon dispersion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalman, G.; Golden, K.I.

The authors question the suggestion that plasmon dispersion increases for small values of the coupling over its random-phase-approximation value, and conclude that, contrary to what has been stated in the literature, it does not: high-frequency-moment sum-rule and Kramers-Kronig arguments, when properly treated, do not entail such a consequence.

46 CFR 15.850 - Lookouts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Lookouts. 15.850 Section 15.850 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Computations § 15.850 Lookouts. The requirements for the maintenance of a proper lookout are specified in Rule 5 of the...

26 CFR 1.1016-2 - Items properly chargeable to capital account.

Code of Federal Regulations, 2011 CFR

2011-04-01

....1016-2 Section 1.1016-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Basis Rules of General Application § 1.1016-2... basis, purchased property in 1941 for $10,000. He subsequently expended $6,000 for improvements...

46 CFR 15.850 - Lookouts.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Lookouts. 15.850 Section 15.850 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Computations § 15.850 Lookouts. The requirements for the maintenance of a proper lookout are specified in Rule 5 of the...

46 CFR 15.850 - Lookouts.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Lookouts. 15.850 Section 15.850 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Computations § 15.850 Lookouts. The requirements for the maintenance of a proper lookout are specified in Rule 5 of the...

46 CFR 15.850 - Lookouts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Lookouts. 15.850 Section 15.850 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Computations § 15.850 Lookouts. (a) The requirements for the maintenance of a proper lookout are specified in Rule 5 of...

46 CFR 15.850 - Lookouts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Lookouts. 15.850 Section 15.850 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Computations § 15.850 Lookouts. The requirements for the maintenance of a proper lookout are specified in Rule 5 of the...

26 CFR 1.6662-4 - Substantial understatement of income tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

...; General Explanations of tax legislation prepared by the Joint Committee on Taxation (the Blue Book... properly substantiated, or the taxpayer failed to keep adequate books and records with respect to the item... an understatement. (iv) Cross-reference. See § 1.6664-4(f) for certain rules regarding the...

78 FR 12015 - Western Pacific Fisheries; Fishing in the Marianas Trench, Pacific Remote Islands, and Rose Atoll...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... submerged lands, waters, and marine resources, which are biologically diverse, contain sites of historical... proper care and management of the monument, including allowing for traditional indigenous fishing... indigenous fishing practices. This proposed rule would implement the Council's recommendations. The Marianas...

46 CFR Sec. 7 - Disbursements at foreign ports.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-agent shall pay invoices from such advances and shall make proper accounting to the agent for all... RULES FOR FINANCIAL TRANSACTIONS UNDER AGENCY AGREEMENTS Disbursements Sec. 7 Disbursements at foreign... or by any other method outlined to and approved by the owner in advance of its use: (a) The agent may...

46 CFR Sec. 6 - Disbursements at other domestic ports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... invoices from such advances and make proper accounting to the agent for each advance supported by invoices... RULES FOR FINANCIAL TRANSACTIONS UNDER AGENCY AGREEMENTS Disbursements Sec. 6 Disbursements at other... agent may advance from time to time from the joint bank account the funds necessary to meet the...

42 CFR 35.63 - Report of and accounting for contributions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT Contributions for the Benefit of Patients § 35.63... (hereinafter referred to as “patient fund”) will be treated consistently with Federal deposit rules and as... contributions for the benefit of patients from proper accountability and control of funds and property. (b...

Quantifying Leg Movement Activity During Sleep.

PubMed

Ferri, Raffaele; Fulda, Stephany

2016-12-01

Currently, 2 sets of similar rules for recording and scoring leg movement (LM) exist, including periodic LM during sleep (PLMS) and periodic LM during wakefulness. The former were published in 2006 by a task force of the International Restless Legs Syndrome Study Group, and the second in 2007 by the American Academy of Sleep Medicine. This article reviews the basic recording methods, scoring rules, and computer-based programs for PLMS. Less frequent LM activities, such as alternating leg muscle activation, hypnagogic foot tremor, high-frequency LMs, and excessive fragmentary myoclonus are briefly described. Copyright © 2016 Elsevier Inc. All rights reserved.

Conflict and Gaming in Instruction and Performance.

ERIC Educational Resources Information Center

Kowitz, Gerald T.; Smith, Jay C.

1989-01-01

Discussion of instruction and training to introduce new ideas and to improve performance focuses on the presence of conflict and the theory of games. Topics discussed include learner participation; Theory X; Theory Y; and Theory Z; and game rules, including control, scoring, changing rules, and ending the game. (25 references) (LRW)

Rule-governed Approaches to Physics--Newton's Third Law.

ERIC Educational Resources Information Center

Maloney, David P.

1984-01-01

Describes an approach to assessing the use of rules in solving problems related to Newton's third law of motion. Discusses the problems used, method of questioning, scoring of problem sets, and a general overview of the use of the technique in aiding the teacher in dealing with student's conceptual levels. (JM)

Automatic Diagnosis of Fetal Heart Rate: Comparison of Different Methodological Approaches

DTIC Science & Technology

2001-10-25

Apgar score). Each recording lasted at least 30 minutes and it contained both the cardiographic series and the toco trace. We focused on four...inference rules automatically generated by the learning procedure showed that n° Rules can be manually reduced to 37 without deteriorating so much the

Optimizing inhaler use by pharmacist-provided education to community-dwelling elderly.

PubMed

Bouwmeester, Carla; Kraft, Jacqueline; Bungay, Kathleen M

2015-10-01

To assess, using a standard observational tool, the ability of patients to demonstrate and maintain proper inhaled medication administration techniques following pharmacist education. Six-month observational study. Patients' homes or adult day health center. Patients in a Program for All-inclusive Care for the Elderly (PACE) prescribed one or more inhaled medications used at least once daily. Instruction by on-site clinical pharmacist. Hickey's Pharmacies Inhaler Technique assessment (score range: 0-20, higher better). Forty-two patients were evaluated at baseline, taught proper techniques for using inhaled medications, assessed immediately following the education, and re-assessed 4-6 weeks later. The mean pre-assessment score was 14 (SD 4.5, range 0-20), the initial post-assessment score increased to 18 (SD 3, range 10-20). The second post-assessment (4-6 weeks later) score mean was 17.7 (SD 3, range 10-20). Both follow-up scores were significantly improved from baseline (p < 0.05). Multivariable analysis indicated the strongest predictors of second post-training score were: score after initial pharmacist training and being subscribed to auto-refill. These characteristics predicted ∼70% of the variance in the second score (p < 0.001). These results indicate that education by a pharmacist combined with an auto-refill program can improve and sustain appropriate inhaler use by community-dwelling elders in a PACE program. The improved score was maintained 4-6 weeks later indicating a sustained benefit of medication administration education. Optimal inhaler use ensures optimal dosing and supports appropriate inhaler treatment in lieu of oral agents. Copyright © 2015 Elsevier Ltd. All rights reserved.

Textiles for protection against microorganism

NASA Astrophysics Data System (ADS)

Sauperl, O.

2016-04-01

Concerning micro-organisms such as bacteria, viruses and fungi, there is a huge progress in the development of textile materials and procedures which should effectively protect against these various pathogens. In this sense there is especially problematic hospital environment, where it is necessary to take into account properly designed textile material which, when good selected and composed, act as a good barrier against transfer of micro-organisms through material mainly in its wet state. Respect to this it is necessary to be familiar with the rules regarding selection of the input material, the choice of proper yarn construction, the choice of the proper weaving mode, the rules regarding selection of antimicrobial-active compound suitable for (eco-friendly) treatment, and the choice of the most appropriate test method by which it is possible objectively to conclude on the reduction of selected microorganism. As is well known, fabrics are three-dimensional structures with void and non-void areas. Therefore, the physical-chemical properties of the textile material/fabric, the surface characteristics together with the shape of microorganism, and the carriers' characteristics contribute to control the transfer of microorganism through textile material. Therefore, careful planning of textile materials and treatment procedure with the compound which is able to reduce micro-organism satisfactory is particularly important, especially due to the fact that in hospital environment population with impaired immune system is mainly presented.

Intramural Gymnastics Competition.

ERIC Educational Resources Information Center

Cornelius, William L.

1981-01-01

An intramural gymnastic competition, if properly organized, can foster student and community interest in gymnastics. Aspects of organization and essential preplanning include: directing, judging, scoring, and managing. (JN)

Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events

PubMed Central

Berry, Richard B.; Budhiraja, Rohit; Gottlieb, Daniel J.; Gozal, David; Iber, Conrad; Kapur, Vishesh K.; Marcus, Carole L.; Mehra, Reena; Parthasarathy, Sairam; Quan, Stuart F.; Redline, Susan; Strohl, Kingman P.; Ward, Sally L. Davidson; Tangredi, Michelle M.

2012-01-01

The American Academy of Sleep Medicine (AASM) Sleep Apnea Definitions Task Force reviewed the current rules for scoring respiratory events in the 2007 AASM Manual for the Scoring and Sleep and Associated Events to determine if revision was indicated. The goals of the task force were (1) to clarify and simplify the current scoring rules, (2) to review evidence for new monitoring technologies relevant to the scoring rules, and (3) to strive for greater concordance between adult and pediatric rules. The task force reviewed the evidence cited by the AASM systematic review of the reliability and validity of scoring respiratory events published in 2007 and relevant studies that have appeared in the literature since that publication. Given the limitations of the published evidence, a consensus process was used to formulate the majority of the task force recommendations concerning revisions. The task force made recommendations concerning recommended and alternative sensors for the detection of apnea and hypopnea to be used during diagnostic and positive airway pressure (PAP) titration polysomnography. An alternative sensor is used if the recommended sensor fails or the signal is inaccurate. The PAP device flow signal is the recommended sensor for the detection of apnea, hypopnea, and respiratory effort related arousals (RERAs) during PAP titration studies. Appropriate filter settings for recording (display) of the nasal pressure signal to facilitate visualization of inspiratory flattening are also specified. The respiratory inductance plethysmography (RIP) signals to be used as alternative sensors for apnea and hypopnea detection are specified. The task force reached consensus on use of the same sensors for adult and pediatric patients except for the following: (1) the end-tidal PCO2 signal can be used as an alternative sensor for apnea detection in children only, and (2) polyvinylidene fluoride (PVDF) belts can be used to monitor respiratory effort (thoracoabdominal belts) and as an alternative sensor for detection of apnea and hypopnea (PVDFsum) only in adults. The task force recommends the following changes to the 2007 respiratory scoring rules. Apnea in adults is scored when there is a drop in the peak signal excursion by ≥ 90% of pre-event baseline using an oronasal thermal sensor (diagnostic study), PAP device flow (titration study), or an alternative apnea sensor, for ≥ 10 seconds. Hypopnea in adults is scored when the peak signal excursions drop by ≥ 30% of pre-event baseline using nasal pressure (diagnostic study), PAP device flow (titration study), or an alternative sensor, for ≥ 10 seconds in association with either ≥ 3% arterial oxygen desaturation or an arousal. Scoring a hypopnea as either obstructive or central is now listed as optional, and the recommended scoring rules are presented. In children an apnea is scored when peak signal excursions drop by ≥ 90% of pre-event baseline using an oronasal thermal sensor (diagnostic study), PAP device flow (titration study), or an alternative sensor; and the event meets duration and respiratory effort criteria for an obstructive, mixed, or central apnea. A central apnea is scored in children when the event meets criteria for an apnea, there is an absence of inspiratory effort throughout the event, and at least one of the following is met: (1) the event is ≥ 20 seconds in duration, (2) the event is associated with an arousal or ≥ 3% oxygen desaturation, (3) (infants under 1 year of age only) the event is associated with a decrease in heart rate to less than 50 beats per minute for at least 5 seconds or less than 60 beats per minute for 15 seconds. A hypopnea is scored in children when the peak signal excursions drop is ≥ 30% of pre-event baseline using nasal pressure (diagnostic study), PAP device flow (titration study), or an alternative sensor, for ≥ the duration of 2 breaths in association with either ≥ 3% oxygen desaturation or an arousal. In children and adults, surrogates of the arterial PCO2 are the end-tidal PCO2 or transcutaneous PCO2 (diagnostic study) or transcutaneous PCO2 (titration study). For adults, sleep hypoventilation is scored when the arterial PCO2 (or surrogate) is > 55 mm Hg for ≥ 10 minutes or there is an increase in the arterial PCO2 (or surrogate) ≥ 10 mm Hg (in comparison to an awake supine value) to a value exceeding 50 mm Hg for ≥ 10 minutes. For pediatric patients hypoventilation is scored when the arterial PCO2 (or surrogate) is > 50 mm Hg for > 25% of total sleep time. In adults Cheyne-Stokes breathing is scored when both of the following are met: (1) there are episodes of ≥ 3 consecutive central apneas and/or central hypopneas separated by a crescendo and decrescendo change in breathing amplitude with a cycle length of at least 40 seconds (typically 45 to 90 seconds), and (2) there are five or more central apneas and/or central hypopneas per hour associated with the crescendo/decrescendo breathing pattern recorded over a minimum of 2 hours of monitoring. Commentary: A commentary on this article appears in this issue on page 621. Citation: Berry RB; Budhiraja R; Gottlieb DJ; Gozal D; Iber C; Kapur VK; Marcus CL; Mehra R; Parthasarathy S; Quan SF; Redline S; Strohl KP; Ward SLD; Tangredi MM. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. J Clin Sleep Med 2012;8(5):597-619. PMID:23066376

Non-localization and localization ROC analyses using clinically based scoring

NASA Astrophysics Data System (ADS)

Paquerault, Sophie; Samuelson, Frank W.; Myers, Kyle J.; Smith, Robert C.

2009-02-01

We are investigating the potential for differences in study conclusions when assessing the estimated impact of a computer-aided detection (CAD) system on readers' performance. The data utilized in this investigation were derived from a multi-reader multi-case observer study involving one hundred mammographic background images to which fixed-size and fixed-intensity Gaussian signals were added, generating a low- and high-intensity signal sets. The study setting allowed CAD assessment in two situations: when CAD sensitivity was 1) superior or 2) lower than the average reader. Seven readers were asked to review each set in the unaided and CAD-aided reading modes, mark and rate their findings. Using this data, we studied the effect on study conclusion of three clinically-based receiver operating characteristic (ROC) scoring definitions. These scoring definitions included both location-specific and non-location-specific rules. The results showed agreement in the estimated impact of CAD on the overall reader performance. In the study setting where CAD sensitivity is superior to the average reader, the mean difference in AUC between the CAD-aided read and unaided read was 0.049 (95%CIs: -0.027; 0.130) for the image scoring definition that is based on non-location-specific rules, and 0.104 (95%CIs: 0.036; 0.174) and 0.090 (95%CIs: 0.031; 0.155) for image scoring definitions that are based on location-specific rules. The increases in AUC were statistically significant for the location-specific scoring definitions. It was further observed that the variance on these estimates was reduced when using the location-specific scoring definitions compared to that using a non-location-specific scoring definition. In the study setting where CAD sensitivity is equivalent or lower than the average reader, the mean differences in AUC are slightly above 0.01 for all image scoring definitions. These increases in AUC were not statistical significant for any of the image scoring definitions. The results on the variance analysis differed from those observed in the other study setting. This investigation furthers our understanding of the relationships between non-localization-specific and localization-specific ROC assessment methodologies and their relevance to clinical practice.

Graduated driver licensing and differential deterrence: The effect of license type on intentions to violate road rules.

PubMed

Poirier, Brigitte; Blais, Etienne; Faubert, Camille

2018-01-01

In keeping with the differential deterrence theory, this article assesses the moderating effect of license type on the relationship between social control and intention to violate road rules. More precisely, the article has two objectives: (1) to assess the effect of license type on intentions to infringe road rules; and (2) to pinpoint mechanisms of social control affecting intentions to violate road rules based on one's type of driver license (a restricted license or a full license). This effect is examined among a sample of 392 young drivers in the province of Quebec, Canada. Drivers taking part in the Graduated Driver Licensing (GDL) program have limited demerit points and there is zero tolerance for drinking-and-driving. Propensity score matching techniques were used to assess the effect of the license type on intentions to violate road rules and on various mechanisms of social control. Regression analyses were then conducted to estimate the moderating effect of license type. Average treatment effects from propensity score matching analyses indicate that respondents with a restricted license have lower levels of intention to infringe road rules. While moral commitment and, to a lesser extent, the perceived risk of arrest are both negatively associated with intentions to violate road rules, the license type moderates the relationship between delinquent peers and intentions to violate road rules. The effect of delinquent peers is reduced among respondents with a restricted driver license. Finally, a diminished capability to resist peer pressure could explain the increased crash risk in months following full licensing. Copyright © 2017 Elsevier Ltd. All rights reserved.

Rules of good practice in the care of laboratory animals used in biomedical research.

PubMed

Valanzano, Angelina

2004-01-01

In recent years, the use of laboratory animals has decreased as a result of the adoption of alternative methods such as in vitro experiments and simulation studies. Nonetheless, animal models continue to be necessary in many fields of biomedical research, giving rise to ethical issues regarding the treatment of these animals. In the present work, a general overview of the rules of good practise in caring for laboratory animals is provided, focussing on housing conditions and the proper means of handling animals, including the importance of the relationship or "bond" between the researcher and the animal.

Biometric image enhancement using decision rule based image fusion techniques

NASA Astrophysics Data System (ADS)

Sagayee, G. Mary Amirtha; Arumugam, S.

2010-02-01

Introducing biometrics into information systems may result in considerable benefits. Most of the researchers confirmed that the finger print is widely used than the iris or face and more over it is the primary choice for most privacy concerned applications. For finger prints applications, choosing proper sensor is at risk. The proposed work deals about, how the image quality can be improved by introducing image fusion technique at sensor levels. The results of the images after introducing the decision rule based image fusion technique are evaluated and analyzed with its entropy levels and root mean square error.

Behavioral and emotional problems in a Kuala Lumpur children's home.

PubMed

Abd Rahman, Fairuz Nazri; Mohd Daud, Tuti Iryani; Nik Jaafar, Nik Ruzyanei; Shah, Shamsul Azhar; Tan, Susan Mooi Koon; Wan Ismail, Wan Salwina

2013-08-01

There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents. A comparative cross-sectional study was carried out where carers from both groups were asked to fill in the translated Bahasa Melayu version of the Child Behavior Check List. Forms for 53 residential care children and 61 classmates were completed. The residential care children had significantly higher scores on the rule-breaking (P < 0.001) and Diagnostic and Statistical Manual of Mental Disorders (DSM) conduct problem subscales (P < 0.001). Residential care children's age significantly correlated with DSM somatic problems (P = 0.03) and post-traumatic stress (P = 0.023). Duration of care was significantly positively correlated with rule-breaking (P = 0.008), DSM conduct problems (P = 0.018) and externalizing scores (P = 0.017). Abuse and neglect cases had higher anxiety and depression scores (P = 0.024). Number of reasons in care positively correlated with several subscales, including total behavioral problem score (P = 0.005). Logistic regression revealed the greater number of reasons for placement a child had was significantly associated with having externalizing scores in the clinical range (P = 0.016). However, after Bonferroni correction, only the initial findings regarding rule-breaking and DSM conduct problem scores remained significant. Challenges exist in managing residential care children in Malaysia, especially regarding externalizing behavior. More studies are required to describe the Malaysian scene. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Behavior of the PCA3 gene in the urine of men with high grade prostatic intraepithelial neoplasia.

PubMed

Morote, Juan; Rigau, Marina; Garcia, Marta; Mir, Carmen; Ballesteros, Carlos; Planas, Jacques; Raventós, Carles X; Placer, José; de Torres, Inés M; Reventós, Jaume; Doll, Andreas

2010-12-01

An ideal marker for the early detection of prostate cancer (PCa) should also differentiate between men with isolated high grade prostatic intraepithelial neoplasia (HGPIN) and those with PCa. Prostate Cancer Gene 3 (PCA3) is a highly specific PCa gene and its score, in relation to the PSA gene in post-prostate massage urine (PMU-PCA3), seems to be useful in ruling out PCa, especially after a negative prostate biopsy. Because PCA3 is also expressed in the HGPIN lesion, the aim of this study was to determine the efficacy of PMU-PCA3 scores for ruling out PCa in men with previous HGPIN. The PMU-PCA3 score was assessed by quantitative PCR (multiplex research assay) in 244 men subjected to prostate biopsy: 64 men with an isolated HGPIN (no cancer detected after two or more repeated biopsies), 83 men with PCa and 97 men with benign pathology findings (BP: no PCa, HGPIN or ASAP). The median PMU-PCA3 score was 1.56 in men with BP, 2.01 in men with HGPIN (p = 0.128) and 9.06 in men with PCa (p = 0.008). The AUC in the ROC analysis was 0.705 in the subset of men with BP and PCa, while it decreased to 0.629 when only men with isolated HGPIN and PCa were included in the analysis. Fixing the sensitivity of the PMU-PCA3 score at 90%, its specificity was 79% in men with BP and 69% in men with isolated HGPIN. The efficacy of the PMU-PCA3 score to rule out PCa in men with HGPIN is lower than in men with BP.

Teaching artificial neural systems to drive: Manual training techniques for autonomous systems

NASA Technical Reports Server (NTRS)

Shepanski, J. F.; Macy, S. A.

1987-01-01

A methodology was developed for manually training autonomous control systems based on artificial neural systems (ANS). In applications where the rule set governing an expert's decisions is difficult to formulate, ANS can be used to extract rules by associating the information an expert receives with the actions taken. Properly constructed networks imitate rules of behavior that permits them to function autonomously when they are trained on the spanning set of possible situations. This training can be provided manually, either under the direct supervision of a system trainer, or indirectly using a background mode where the networks assimilates training data as the expert performs its day-to-day tasks. To demonstrate these methods, an ANS network was trained to drive a vehicle through simulated freeway traffic.

Toward sensor-based context aware systems.

PubMed

Sakurai, Yoshitaka; Takada, Kouhei; Anisetti, Marco; Bellandi, Valerio; Ceravolo, Paolo; Damiani, Ernesto; Tsuruta, Setsuo

2012-01-01

This paper proposes a methodology for sensor data interpretation that can combine sensor outputs with contexts represented as sets of annotated business rules. Sensor readings are interpreted to generate events labeled with the appropriate type and level of uncertainty. Then, the appropriate context is selected. Reconciliation of different uncertainty types is achieved by a simple technique that moves uncertainty from events to business rules by generating combs of standard Boolean predicates. Finally, context rules are evaluated together with the events to take a decision. The feasibility of our idea is demonstrated via a case study where a context-reasoning engine has been connected to simulated heartbeat sensors using prerecorded experimental data. We use sensor outputs to identify the proper context of operation of a system and trigger decision-making based on context information.

Association Rule Analysis for Tour Route Recommendation and Application to Wctsnop

NASA Astrophysics Data System (ADS)

Fang, H.; Chen, C.; Lin, J.; Liu, X.; Fang, D.

2017-09-01

The increasing E-tourism systems provide intelligent tour recommendation for tourists. In this sense, recommender system can make personalized suggestions and provide satisfied information associated with their tour cycle. Data mining is a proper tool that extracting potential information from large database for making strategic decisions. In the study, association rule analysis based on FP-growth algorithm is applied to find the association relationship among scenic spots in different cities as tour route recommendation. In order to figure out valuable rules, Kulczynski interestingness measure is adopted and imbalance ratio is computed. The proposed scheme was evaluated on Wangluzhe cultural tourism service network operation platform (WCTSNOP), where it could verify that it is able to quick recommend tour route and to rapidly enhance the recommendation quality.

Interpretation and Utilization of Scores on the Air Force Officer Qualifying Test.

ERIC Educational Resources Information Center

Miller, Robert E.

The report summarizes a large body of data relevant to the proper interpretation and use of aptitude scores on the Air Force Officer Qualifying Test (AFOQT). Included are descriptions of the AFOQT testing program and the test itself. Technical data include an extensive sampling of validation studies covering predictors of success in pilot…

[The diagnostic and the exclusion scores for pulmonary embolism].

PubMed

Junod, A

2015-05-27

Several clinical scores for the diagnosis of pulmonary embolism (PE) have been published. The most popular ones are the Wells score and the revised Geneva score; simplified versions exist for these two scores; they have been validated. Both scores have common properties, but there is a major difference for the Wells score, namely the inclusion of a feature based on clinical judgment. These two scores in combination with D-dimers measurement have been used to rule out PE. An important improvement in this process has recently taken place with the use of an adjustable, age-dependent threshold for DD for patients over 50 years.

A Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis.

PubMed

Jang, E-Wook; Chung, Joonho; Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Lee, Kyung-Yul

2015-06-01

There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis. A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established. CEA or CAS is indicated when the patient has a symptomatic stenosis ≥ 50%, or when the patient has an asymptomatic stenosis ≥ 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected. We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.

Results of the Minnesota Multiphasic Personality Inventory-2 among gestational surrogacy candidates.

PubMed

Klock, Susan C; Covington, Sharon N

2015-09-01

To obtain normative data on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) personality test for gestational surrogate (GS) candidates. A retrospective study was undertaken through chart review of all GS candidates assessed at Shady Grove Fertility Center, Rockville, MD, USA, between June 2007 and December 2009. Participants completed the MMPI-2 test during screening. MMPI-2 scores, demographic information, and screening outcome were retrieved. Among 153 included candidates, 132 (86.3%) were accepted to be a GS, 6 (3.9%) were ruled out because of medical reasons, and 15 (9.8%) were ruled out because of psychological reasons. The mean scores on each of the MMPI-2 scales were within the normal range. A score of more than 65 (the clinical cutoff) was recorded on the L scale for 46 (30.1%) candidates, on the K scale for 61 (39.9%), and on the S scale for 84 (54.9%). Women who were ruled out for psychological reasons had significantly higher mean scores on the validity scales F and L, and on clinical scale 8 than did women who were accepted (P<0.05 for all). Most GS candidates are well adjusted and free of psychopathology, but candidates tend to present themselves in an overly positive way. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

A Collaborative Educational Association Rule Mining Tool

ERIC Educational Resources Information Center

Garcia, Enrique; Romero, Cristobal; Ventura, Sebastian; de Castro, Carlos

2011-01-01

This paper describes a collaborative educational data mining tool based on association rule mining for the ongoing improvement of e-learning courses and allowing teachers with similar course profiles to share and score the discovered information. The mining tool is oriented to be used by non-expert instructors in data mining so its internal…

Estimating Classification Accuracy for Complex Decision Rules Based on Multiple Scores

ERIC Educational Resources Information Center

Douglas, Karen M.; Mislevy, Robert J.

2010-01-01

Important decisions about students are made by combining multiple measures using complex decision rules. Although methods for characterizing the accuracy of decisions based on a single measure have been suggested by numerous researchers, such methods are not useful for estimating the accuracy of decisions based on multiple measures. This study…

Whole-body multislice computed tomography as the primary and sole diagnostic tool in patients with blunt trauma: searching for its appropriate indication.

PubMed

Wurmb, Thomas Erik; Frühwald, Peter; Hopfner, Wittiko; Roewer, Norbert; Brederlau, Jörg

2007-11-01

In our hospital, whole-body multislice computed tomography is used as the primary diagnostic tool in patients with suspected multiple trauma. A triage rule is used for its indication. We have retrospectively analyzed data of sedated, intubated and ventilated patients consecutively admitted to our trauma center to assess whether the triage rule can help identify patients with severe trauma (injury severity score > or = 16). We have found that overtriage (injury severity score < 16) occurs in 30%, and undertriage occurs in 6% of patients. Although we have found the triage rule to be highly sensitive, this results in a high rate of overtriage. Until we know more about the most relevant and independent predictive factors, sole reliance upon multislice computed tomography in triaging suspected polytrauma victims will imply the risk to overscan many patients.

47 CFR 1.1910 - Effect of insufficient fee payments, delinquent debts, or debarment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... determine if the applicant has paid the appropriate application fee, appropriate regulatory fees, is... proper application or regulatory fee will be handled pursuant to the rules set forth in 47 CFR part 1... challenge through an administrative appeal or a contested judicial proceeding either to the existence or...

76 FR 38997 - Approval and Promulgation of Implementation Plans; State of Oregon; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... economic blow that would result from an earlier closure and is an appropriate balance of environmental and... BART rules for the Boardman facility achieve the proper balance of environmental benefits, the cost to... secure greater environmental benefits with a better balance of cost and risk by transitioning the...

47 CFR 95.424 - (CB Rule 24) How do I have my CB station transmitter serviced?

Code of Federal Regulations, 2010 CFR

2010-10-01

... transmitter serviced? 95.424 Section 95.424 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... maintenance as often as may be necessary to ensure proper operation. You must have all internal repairs or internal adjustments to your CB transmitter made in accordance with the Technical Regulations (see subpart...

26 CFR 1.851-3 - Rules applicable to section 851(b)(4).

Code of Federal Regulations, 2012 CFR

2012-04-01

... TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment... investment in the securities of any one issuer, for the purposes of subparagraph (B) of section 851(b)(4), there shall be included its proper proportion of the investment of any other corporation, a member of a...

26 CFR 1.851-3 - Rules applicable to section 851(b)(4).

Code of Federal Regulations, 2013 CFR

2013-04-01

... TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment... investment in the securities of any one issuer, for the purposes of subparagraph (B) of section 851(b)(4), there shall be included its proper proportion of the investment of any other corporation, a member of a...

26 CFR 1.851-3 - Rules applicable to section 851(b)(4).

Code of Federal Regulations, 2011 CFR

2011-04-01

... TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment... investment in the securities of any one issuer, for the purposes of subparagraph (B) of section 851(b)(4), there shall be included its proper proportion of the investment of any other corporation, a member of a...

26 CFR 1.851-3 - Rules applicable to section 851(b)(4).

Code of Federal Regulations, 2014 CFR

2014-04-01

... TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment... investment in the securities of any one issuer, for the purposes of subparagraph (B) of section 851(b)(4), there shall be included its proper proportion of the investment of any other corporation, a member of a...

77 FR 20051 - Meeting of the Compact Council for the National Crime Prevention and Privacy Compact

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... provides a legal framework for the establishment of a cooperative federal-state system to exchange such... on the Council. The Council will prescribe system rules and procedures for the effective and proper operation of the Interstate Identification Index system for noncriminal justice purposes. Matters for...

76 FR 20044 - Meeting of the Compact Council for the National Crime Prevention and Privacy Compact

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... provides a legal framework for the establishment of a cooperative Federal-State system to exchange such... on the Council. The Council will prescribe system rules and procedures for the effective and proper operation of the Interstate Identification Index system for noncriminal justice purposes. Matters for...

78 FR 61384 - Meeting of the Compact Council for the National Crime Prevention and Privacy Compact

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

... provides a legal framework for the establishment of a cooperative federal-state system to exchange such... on the Council. The Council will prescribe system rules and procedures for the effective and proper operation of the Interstate Identification Index system for noncriminal justice purposes. Matters for...

77 FR 60475 - Meeting of the Compact Council for the National Crime Prevention and Privacy Compact

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... provides a legal framework for the establishment of a cooperative federal-state system to exchange such... on the Council. The Council will prescribe system rules and procedures for the effective and proper operation of the Interstate Identification Index system for noncriminal justice purposes. Matters for...

75 FR 17161 - Meeting of the Compact Council for the National Crime Prevention and Privacy Compact

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

... Compact also provides a legal framework for the establishment of a cooperative federal-state system to... agencies to serve on the Council. The Council will prescribe system rules and procedures for the effective and proper operation of the Interstate Identification Index system. Matters for discussion are...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2011 CFR

2011-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2010 CFR

2010-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

Cut income taxes with reorganization planning.

PubMed

Miller, J E

1985-04-01

It is necessary to plan when reorganizing a corporate structure, to minimize taxes at the tax-exempt parent organization level and avoid unexpected tax consequences at year-end. With an awareness of the income tax rules, proper debt structuring during the reorganization phase is possible and should enable the financial manager to minimize total income tax.

14 CFR 137.42 - Fastening of safety belts and shoulder harnesses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Fastening of safety belts and shoulder... AGRICULTURAL AIRCRAFT OPERATIONS Operating Rules § 137.42 Fastening of safety belts and shoulder harnesses. No... belt and shoulder harness properly secured about that person except that the shoulder harness need not...

14 CFR 137.42 - Fastening of safety belts and shoulder harnesses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Fastening of safety belts and shoulder... AGRICULTURAL AIRCRAFT OPERATIONS Operating Rules § 137.42 Fastening of safety belts and shoulder harnesses. No... belt and shoulder harness properly secured about that person except that the shoulder harness need not...

14 CFR 137.42 - Fastening of safety belts and shoulder harnesses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Fastening of safety belts and shoulder... AGRICULTURAL AIRCRAFT OPERATIONS Operating Rules § 137.42 Fastening of safety belts and shoulder harnesses. No... belt and shoulder harness properly secured about that person except that the shoulder harness need not...

14 CFR 137.42 - Fastening of safety belts and shoulder harnesses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Fastening of safety belts and shoulder... AGRICULTURAL AIRCRAFT OPERATIONS Operating Rules § 137.42 Fastening of safety belts and shoulder harnesses. No... belt and shoulder harness properly secured about that person except that the shoulder harness need not...

14 CFR 137.42 - Fastening of safety belts and shoulder harnesses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Fastening of safety belts and shoulder... AGRICULTURAL AIRCRAFT OPERATIONS Operating Rules § 137.42 Fastening of safety belts and shoulder harnesses. No... belt and shoulder harness properly secured about that person except that the shoulder harness need not...

14 CFR Appendix A to Part 129 - Application for Operations Specifications by Foreign Air Carriers

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Operations. State whether the operation proposed is day or night, visual flight rules, instrument flight...). Sec. IV. Communications facilities. List all communication facilities to be used by the applicant in... English language to a degree necessary to enable them to properly communicate with Airport Traffic Control...

An Evaluation and Analysis of Past Landfill Closures in Puerto Rico as Guidance for Current and Future Closures

EPA Science Inventory

The island of Puerto Rico has faced several challenges related to the issue of closed landfills – historically, many municipal landfills in Puerto Rico were not closed properly or abandoned, while others were closed in accordance with applicable rules but have sustained physical ...

31 CFR 321.22 - Forwarding securities not payable by an agent.

Code of Federal Regulations, 2014 CFR

2014-07-01

... must follow. These instructions are available from a TRS Site or online at www.treasurydirect.gov. [77... TRS Site. The requests for payment on the securities should be properly certified. Any documentary... TRS Site in accordance with the rules in this part. The Bureau of the Fiscal Service provides agents...

31 CFR 321.22 - Forwarding securities not payable by an agent.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... These instructions are available from a TRS Site or online at www.treasurydirect.gov. [77 FR 16167, Mar... TRS Site. The requests for payment on the securities should be properly certified. Any documentary... TRS Site in accordance with the rules in this part. The Bureau of the Public Debt provides agents with...

31 CFR 321.22 - Forwarding securities not payable by an agent.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... These instructions are available from a TRS Site or online at www.treasurydirect.gov. [77 FR 16167, Mar... TRS Site. The requests for payment on the securities should be properly certified. Any documentary... TRS Site in accordance with the rules in this part. The Bureau of the Public Debt provides agents with...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2013 CFR

2013-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2014 CFR

2014-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2012 CFR

2012-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

75 FR 36479 - Proposed Collection; Comment Request for Form 1099-INT

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-25

... on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of... Code. The IRS uses the form to verify compliance with the reporting rules and to verify that the recipient has included the proper amount of interest on his or her income tax return. Current Actions: There...

78 FR 31632 - Proposed Collection; Comment Request for Form 1099-INT

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... on proposed and/or continuing information collections, as required by the Paperwork Reduction Act of... Code. The IRS uses the form to verify compliance with the reporting rules and to verify that the recipient has included the proper amount of interest on his or her income tax return. Current Actions: There...

A Cross-Correlated Delay Shift Supervised Learning Method for Spiking Neurons with Application to Interictal Spike Detection in Epilepsy.

PubMed

Guo, Lilin; Wang, Zhenzhong; Cabrerizo, Mercedes; Adjouadi, Malek

2017-05-01

This study introduces a novel learning algorithm for spiking neurons, called CCDS, which is able to learn and reproduce arbitrary spike patterns in a supervised fashion allowing the processing of spatiotemporal information encoded in the precise timing of spikes. Unlike the Remote Supervised Method (ReSuMe), synapse delays and axonal delays in CCDS are variants which are modulated together with weights during learning. The CCDS rule is both biologically plausible and computationally efficient. The properties of this learning rule are investigated extensively through experimental evaluations in terms of reliability, adaptive learning performance, generality to different neuron models, learning in the presence of noise, effects of its learning parameters and classification performance. Results presented show that the CCDS learning method achieves learning accuracy and learning speed comparable with ReSuMe, but improves classification accuracy when compared to both the Spike Pattern Association Neuron (SPAN) learning rule and the Tempotron learning rule. The merit of CCDS rule is further validated on a practical example involving the automated detection of interictal spikes in EEG records of patients with epilepsy. Results again show that with proper encoding, the CCDS rule achieves good recognition performance.

The bacterial meningitis score to distinguish bacterial from aseptic meningitis in children from Sao Paulo, Brazil.

PubMed

Mekitarian Filho, Eduardo; Horita, Sérgio Massaru; Gilio, Alfredo Elias; Alves, Anna Cláudia Dominguez; Nigrovic, Lise E

2013-09-01

In a retrospective cohort of 494 children with meningitis in Sao Paulo, Brazil, the Bacterial Meningitis Score identified all the children with bacterial meningitis (sensitivity 100%, 95% confidence interval: 92-100% and negative predictive value 100%, 95% confidence interval: 98-100%). Addition of cerebrospinal fluid lactate to the score did not improve clinical prediction rule performance.

A validation study of a clinical prediction rule for screening asymptomatic chlamydia and gonorrhoea infections among heterosexuals in British Columbia.

PubMed

Falasinnu, Titilola; Gilbert, Mark; Gustafson, Paul; Shoveller, Jean

2016-02-01

One component of effective sexually transmitted infections (STIs) control is ensuring those at highest risk of STIs have access to clinical services because terminating transmission in this group will prevent most future cases. Here, we describe the results of a validation study of a clinical prediction rule for identifying individuals at increased risk for chlamydia and gonorrhoea infection derived in Vancouver, British Columbia (BC), against a population of asymptomatic patients attending sexual health clinics in other geographical settings in BC. We examined electronic records (2000-2012) from clinic visits at seven sexual health clinics in geographical locations outside Vancouver. The model's calibration and discrimination were examined by the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow (H-L) statistic, respectively. We also examined the sensitivity and proportion of patients that would need to be screened at different cut-offs of the risk score. The prevalence of infection was 5.3% (n=10 425) in the geographical validation population. The prediction rule showed good performance in this population (AUC, 0.69; H-L p=0.26). Possible risk scores ranged from -2 to 27. We identified a risk score cut-off point of ≥8 that detected cases with a sensitivity of 86% by screening 63% of the geographical validation population. The prediction rule showed good generalisability in STI clinics outside of Vancouver with improved discriminative performance compared with temporal validation. The prediction rule has the potential for augmenting triaging services in STI clinics and enhancing targeted testing in population-based screening programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Development of clinical decision rules to predict recurrent shock in dengue

PubMed Central

2013-01-01

Introduction Mortality from dengue infection is mostly due to shock. Among dengue patients with shock, approximately 30% have recurrent shock that requires a treatment change. Here, we report development of a clinical rule for use during a patient’s first shock episode to predict a recurrent shock episode. Methods The study was conducted in Center for Preventive Medicine in Vinh Long province and the Children’s Hospital No. 2 in Ho Chi Minh City, Vietnam. We included 444 dengue patients with shock, 126 of whom had recurrent shock (28%). Univariate and multivariate analyses and a preprocessing method were used to evaluate and select 14 clinical and laboratory signs recorded at shock onset. Five variables (admission day, purpura/ecchymosis, ascites/pleural effusion, blood platelet count and pulse pressure) were finally trained and validated by a 10-fold validation strategy with 10 times of repetition, using a logistic regression model. Results The results showed that shorter admission day (fewer days prior to admission), purpura/ecchymosis, ascites/pleural effusion, low platelet count and narrow pulse pressure were independently associated with recurrent shock. Our logistic prediction model was capable of predicting recurrent shock when compared to the null method (P < 0.05) and was not outperformed by other prediction models. Our final scoring rule provided relatively good accuracy (AUC, 0.73; sensitivity and specificity, 68%). Score points derived from the logistic prediction model revealed identical accuracy with AUCs at 0.73. Using a cutoff value greater than −154.5, our simple scoring rule showed a sensitivity of 68.3% and a specificity of 68.2%. Conclusions Our simple clinical rule is not to replace clinical judgment, but to help clinicians predict recurrent shock during a patient’s first dengue shock episode. PMID:24295509

An algorithm for automated layout of process description maps drawn in SBGN.

PubMed

Genc, Begum; Dogrusoz, Ugur

2016-01-01

Evolving technology has increased the focus on genomics. The combination of today's advanced techniques with decades of molecular biology research has yielded huge amounts of pathway data. A standard, named the Systems Biology Graphical Notation (SBGN), was recently introduced to allow scientists to represent biological pathways in an unambiguous, easy-to-understand and efficient manner. Although there are a number of automated layout algorithms for various types of biological networks, currently none specialize on process description (PD) maps as defined by SBGN. We propose a new automated layout algorithm for PD maps drawn in SBGN. Our algorithm is based on a force-directed automated layout algorithm called Compound Spring Embedder (CoSE). On top of the existing force scheme, additional heuristics employing new types of forces and movement rules are defined to address SBGN-specific rules. Our algorithm is the only automatic layout algorithm that properly addresses all SBGN rules for drawing PD maps, including placement of substrates and products of process nodes on opposite sides, compact tiling of members of molecular complexes and extensively making use of nested structures (compound nodes) to properly draw cellular locations and molecular complex structures. As demonstrated experimentally, the algorithm results in significant improvements over use of a generic layout algorithm such as CoSE in addressing SBGN rules on top of commonly accepted graph drawing criteria. An implementation of our algorithm in Java is available within ChiLay library (https://github.com/iVis-at-Bilkent/chilay). ugur@cs.bilkent.edu.tr or dogrusoz@cbio.mskcc.org Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

An algorithm for automated layout of process description maps drawn in SBGN

PubMed Central

Genc, Begum; Dogrusoz, Ugur

2016-01-01

Motivation: Evolving technology has increased the focus on genomics. The combination of today’s advanced techniques with decades of molecular biology research has yielded huge amounts of pathway data. A standard, named the Systems Biology Graphical Notation (SBGN), was recently introduced to allow scientists to represent biological pathways in an unambiguous, easy-to-understand and efficient manner. Although there are a number of automated layout algorithms for various types of biological networks, currently none specialize on process description (PD) maps as defined by SBGN. Results: We propose a new automated layout algorithm for PD maps drawn in SBGN. Our algorithm is based on a force-directed automated layout algorithm called Compound Spring Embedder (CoSE). On top of the existing force scheme, additional heuristics employing new types of forces and movement rules are defined to address SBGN-specific rules. Our algorithm is the only automatic layout algorithm that properly addresses all SBGN rules for drawing PD maps, including placement of substrates and products of process nodes on opposite sides, compact tiling of members of molecular complexes and extensively making use of nested structures (compound nodes) to properly draw cellular locations and molecular complex structures. As demonstrated experimentally, the algorithm results in significant improvements over use of a generic layout algorithm such as CoSE in addressing SBGN rules on top of commonly accepted graph drawing criteria. Availability and implementation: An implementation of our algorithm in Java is available within ChiLay library (https://github.com/iVis-at-Bilkent/chilay). Contact: ugur@cs.bilkent.edu.tr or dogrusoz@cbio.mskcc.org Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26363029

Virtue vs utility: Alternative foundations for computer ethics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Artz, J.M.

1994-12-31

Ethical decisions within the field of computers and information systems are made at two levels by two distinctly different groups of people. At the level of general principles, ethical issues are debated by academics and industry representatives in an attempt to decide what is proper behavior on issues such as hacking, privacy, and copying software. At another level, that of particular situations, individuals make ethical decisions regarding what is good and proper for them in their particular situation. They may use the general rules provided by the experts or they may decide that these rules do not apply in theirmore » particular situation. Currently, the literature on computer ethics provides some opinions regarding the general rules, and some guidance for developing further general rules. What is missing is guidance for individuals making ethical decisions in particular situations. For the past two hundred years, ethics has been dominated by conduct based ethical theories such as utilitarianism which attempt to describe how people must be behave in order to be moral individuals. Recently, weaknesses in conduct based approaches such as utilitarianism have led moral philosophers to reexamine character based ethical theories such as virtue ethics which dates back to the Greek philosophers Plato and Aristotle. This paper will compare utilitarianism and virtue ethics with respect to the foundations they provide for computer ethics. It will be argued that the very nature of computer ethics and the need to provide guidance to individuals making particular moral decisions points to the ethics of virtue as a superior philosophical foundation for computer ethics. The paper will conclude with the implications of this position for researchers, teachers and writers within the field of computer ethics.« less

SPSS and SAS programs for determining the number of components using parallel analysis and velicer's MAP test.

PubMed

O'Connor, B P

2000-08-01

Popular statistical software packages do not have the proper procedures for determining the number of components in factor and principal components analyses. Parallel analysis and Velicer's minimum average partial (MAP) test are validated procedures, recommended widely by statisticians. However, many researchers continue to use alternative, simpler, but flawed procedures, such as the eigenvalues-greater-than-one rule. Use of the proper procedures might be increased if these procedures could be conducted within familiar software environments. This paper describes brief and efficient programs for using SPSS and SAS to conduct parallel analyses and the MAP test.

From data mining rules to medical logical modules and medical advices.

PubMed

Gomoi, Valentin; Vida, Mihaela; Robu, Raul; Stoicu-Tivadar, Vasile; Bernad, Elena; Lupşe, Oana

2013-01-01

Using data mining in collaboration with Clinical Decision Support Systems adds new knowledge as support for medical diagnosis. The current work presents a tool which translates data mining rules supporting generation of medical advices to Arden Syntax formalism. The developed system was tested with data related to 2326 births that took place in 2010 at the Bega Obstetrics - Gynaecology Hospital, Timişoara. Based on processing these data, 14 medical rules regarding the Apgar score were generated and then translated in Arden Syntax language.

Precise-spike-driven synaptic plasticity: learning hetero-association of spatiotemporal spike patterns.

PubMed

Yu, Qiang; Tang, Huajin; Tan, Kay Chen; Li, Haizhou

2013-01-01

A new learning rule (Precise-Spike-Driven (PSD) Synaptic Plasticity) is proposed for processing and memorizing spatiotemporal patterns. PSD is a supervised learning rule that is analytically derived from the traditional Widrow-Hoff rule and can be used to train neurons to associate an input spatiotemporal spike pattern with a desired spike train. Synaptic adaptation is driven by the error between the desired and the actual output spikes, with positive errors causing long-term potentiation and negative errors causing long-term depression. The amount of modification is proportional to an eligibility trace that is triggered by afferent spikes. The PSD rule is both computationally efficient and biologically plausible. The properties of this learning rule are investigated extensively through experimental simulations, including its learning performance, its generality to different neuron models, its robustness against noisy conditions, its memory capacity, and the effects of its learning parameters. Experimental results show that the PSD rule is capable of spatiotemporal pattern classification, and can even outperform a well studied benchmark algorithm with the proposed relative confidence criterion. The PSD rule is further validated on a practical example of an optical character recognition problem. The results again show that it can achieve a good recognition performance with a proper encoding. Finally, a detailed discussion is provided about the PSD rule and several related algorithms including tempotron, SPAN, Chronotron and ReSuMe.

Precise-Spike-Driven Synaptic Plasticity: Learning Hetero-Association of Spatiotemporal Spike Patterns

PubMed Central

Yu, Qiang; Tang, Huajin; Tan, Kay Chen; Li, Haizhou

2013-01-01

A new learning rule (Precise-Spike-Driven (PSD) Synaptic Plasticity) is proposed for processing and memorizing spatiotemporal patterns. PSD is a supervised learning rule that is analytically derived from the traditional Widrow-Hoff rule and can be used to train neurons to associate an input spatiotemporal spike pattern with a desired spike train. Synaptic adaptation is driven by the error between the desired and the actual output spikes, with positive errors causing long-term potentiation and negative errors causing long-term depression. The amount of modification is proportional to an eligibility trace that is triggered by afferent spikes. The PSD rule is both computationally efficient and biologically plausible. The properties of this learning rule are investigated extensively through experimental simulations, including its learning performance, its generality to different neuron models, its robustness against noisy conditions, its memory capacity, and the effects of its learning parameters. Experimental results show that the PSD rule is capable of spatiotemporal pattern classification, and can even outperform a well studied benchmark algorithm with the proposed relative confidence criterion. The PSD rule is further validated on a practical example of an optical character recognition problem. The results again show that it can achieve a good recognition performance with a proper encoding. Finally, a detailed discussion is provided about the PSD rule and several related algorithms including tempotron, SPAN, Chronotron and ReSuMe. PMID:24223789

RIDES: Robust Intrusion Detection System for IP-Based Ubiquitous Sensor Networks

PubMed Central

Amin, Syed Obaid; Siddiqui, Muhammad Shoaib; Hong, Choong Seon; Lee, Sungwon

2009-01-01

The IP-based Ubiquitous Sensor Network (IP-USN) is an effort to build the “Internet of things”. By utilizing IP for low power networks, we can benefit from existing well established tools and technologies of IP networks. Along with many other unresolved issues, securing IP-USN is of great concern for researchers so that future market satisfaction and demands can be met. Without proper security measures, both reactive and proactive, it is hard to envisage an IP-USN realm. In this paper we present a design of an IDS (Intrusion Detection System) called RIDES (Robust Intrusion DEtection System) for IP-USN. RIDES is a hybrid intrusion detection system, which incorporates both Signature and Anomaly based intrusion detection components. For signature based intrusion detection this paper only discusses the implementation of distributed pattern matching algorithm with the help of signature-code, a dynamically created attack-signature identifier. Other aspects, such as creation of rules are not discussed. On the other hand, for anomaly based detection we propose a scoring classifier based on the SPC (Statistical Process Control) technique called CUSUM charts. We also investigate the settings and their effects on the performance of related parameters for both of the components. PMID:22412321

RIDES: Robust Intrusion Detection System for IP-Based Ubiquitous Sensor Networks.

PubMed

Amin, Syed Obaid; Siddiqui, Muhammad Shoaib; Hong, Choong Seon; Lee, Sungwon

2009-01-01

The IP-based Ubiquitous Sensor Network (IP-USN) is an effort to build the "Internet of things". By utilizing IP for low power networks, we can benefit from existing well established tools and technologies of IP networks. Along with many other unresolved issues, securing IP-USN is of great concern for researchers so that future market satisfaction and demands can be met. Without proper security measures, both reactive and proactive, it is hard to envisage an IP-USN realm. In this paper we present a design of an IDS (Intrusion Detection System) called RIDES (Robust Intrusion DEtection System) for IP-USN. RIDES is a hybrid intrusion detection system, which incorporates both Signature and Anomaly based intrusion detection components. For signature based intrusion detection this paper only discusses the implementation of distributed pattern matching algorithm with the help of signature-code, a dynamically created attack-signature identifier. Other aspects, such as creation of rules are not discussed. On the other hand, for anomaly based detection we propose a scoring classifier based on the SPC (Statistical Process Control) technique called CUSUM charts. We also investigate the settings and their effects on the performance of related parameters for both of the components.

Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine.

PubMed

Berry, Richard B; Budhiraja, Rohit; Gottlieb, Daniel J; Gozal, David; Iber, Conrad; Kapur, Vishesh K; Marcus, Carole L; Mehra, Reena; Parthasarathy, Sairam; Quan, Stuart F; Redline, Susan; Strohl, Kingman P; Davidson Ward, Sally L; Tangredi, Michelle M

2012-10-15

The American Academy of Sleep Medicine (AASM) Sleep Apnea Definitions Task Force reviewed the current rules for scoring respiratory events in the 2007 AASM Manual for the Scoring and Sleep and Associated Events to determine if revision was indicated. The goals of the task force were (1) to clarify and simplify the current scoring rules, (2) to review evidence for new monitoring technologies relevant to the scoring rules, and (3) to strive for greater concordance between adult and pediatric rules. The task force reviewed the evidence cited by the AASM systematic review of the reliability and validity of scoring respiratory events published in 2007 and relevant studies that have appeared in the literature since that publication. Given the limitations of the published evidence, a consensus process was used to formulate the majority of the task force recommendations concerning revisions.The task force made recommendations concerning recommended and alternative sensors for the detection of apnea and hypopnea to be used during diagnostic and positive airway pressure (PAP) titration polysomnography. An alternative sensor is used if the recommended sensor fails or the signal is inaccurate. The PAP device flow signal is the recommended sensor for the detection of apnea, hypopnea, and respiratory effort related arousals (RERAs) during PAP titration studies. Appropriate filter settings for recording (display) of the nasal pressure signal to facilitate visualization of inspiratory flattening are also specified. The respiratory inductance plethysmography (RIP) signals to be used as alternative sensors for apnea and hypopnea detection are specified. The task force reached consensus on use of the same sensors for adult and pediatric patients except for the following: (1) the end-tidal PCO(2) signal can be used as an alternative sensor for apnea detection in children only, and (2) polyvinylidene fluoride (PVDF) belts can be used to monitor respiratory effort (thoracoabdominal belts) and as an alternative sensor for detection of apnea and hypopnea (PVDFsum) only in adults.The task force recommends the following changes to the 2007 respiratory scoring rules. Apnea in adults is scored when there is a drop in the peak signal excursion by ≥ 90% of pre-event baseline using an oronasal thermal sensor (diagnostic study), PAP device flow (titration study), or an alternative apnea sensor, for ≥ 10 seconds. Hypopnea in adults is scored when the peak signal excursions drop by ≥ 30% of pre-event baseline using nasal pressure (diagnostic study), PAP device flow (titration study), or an alternative sensor, for ≥ 10 seconds in association with either ≥ 3% arterial oxygen desaturation or an arousal. Scoring a hypopnea as either obstructive or central is now listed as optional, and the recommended scoring rules are presented. In children an apnea is scored when peak signal excursions drop by ≥ 90% of pre-event baseline using an oronasal thermal sensor (diagnostic study), PAP device flow (titration study), or an alternative sensor; and the event meets duration and respiratory effort criteria for an obstructive, mixed, or central apnea. A central apnea is scored in children when the event meets criteria for an apnea, there is an absence of inspiratory effort throughout the event, and at least one of the following is met: (1) the event is ≥ 20 seconds in duration, (2) the event is associated with an arousal or ≥ 3% oxygen desaturation, (3) (infants under 1 year of age only) the event is associated with a decrease in heart rate to less than 50 beats per minute for at least 5 seconds or less than 60 beats per minute for 15 seconds. A hypopnea is scored in children when the peak signal excursions drop is ≥ 30% of pre-event baseline using nasal pressure (diagnostic study), PAP device flow (titration study), or an alternative sensor, for ≥ the duration of 2 breaths in association with either ≥ 3% oxygen desaturation or an arousal. In children and adults, surrogates of the arterial PCO(2) are the end-tidal PCO(2) or transcutaneous PCO(2) (diagnostic study) or transcutaneous PCO(2) (titration study). For adults, sleep hypoventilation is scored when the arterial PCO(2) (or surrogate) is > 55 mm Hg for ≥ 10 minutes or there is an increase in the arterial PCO(2) (or surrogate) ≥ 10 mm Hg (in comparison to an awake supine value) to a value exceeding 50 mm Hg for ≥ 10 minutes. For pediatric patients hypoventilation is scored when the arterial PCO(2) (or surrogate) is > 50 mm Hg for > 25% of total sleep time. In adults Cheyne-Stokes breathing is scored when both of the following are met: (1) there are episodes of ≥ 3 consecutive central apneas and/or central hypopneas separated by a crescendo and decrescendo change in breathing amplitude with a cycle length of at least 40 seconds (typically 45 to 90 seconds), and (2) there are five or more central apneas and/or central hypopneas per hour associated with the crescendo/decrescendo breathing pattern recorded over a minimum of 2 hours of monitoring.

Evolving optimised decision rules for intrusion detection using particle swarm paradigm

NASA Astrophysics Data System (ADS)

Sivatha Sindhu, Siva S.; Geetha, S.; Kannan, A.

2012-12-01

The aim of this article is to construct a practical intrusion detection system (IDS) that properly analyses the statistics of network traffic pattern and classify them as normal or anomalous class. The objective of this article is to prove that the choice of effective network traffic features and a proficient machine-learning paradigm enhances the detection accuracy of IDS. In this article, a rule-based approach with a family of six decision tree classifiers, namely Decision Stump, C4.5, Naive Baye's Tree, Random Forest, Random Tree and Representative Tree model to perform the detection of anomalous network pattern is introduced. In particular, the proposed swarm optimisation-based approach selects instances that compose training set and optimised decision tree operate over this trained set producing classification rules with improved coverage, classification capability and generalisation ability. Experiment with the Knowledge Discovery and Data mining (KDD) data set which have information on traffic pattern, during normal and intrusive behaviour shows that the proposed algorithm produces optimised decision rules and outperforms other machine-learning algorithm.

Cost allocation methodology applicable to the temporary assistance for needy families program. Final rule.

PubMed

2008-07-23

This final rule applies to the Temporary Assistance for Needy Families (TANF) program and requires States, the District of Columbia and the Territories (hereinafter referred to as the "States") to use the "benefiting program" cost allocation methodology in U.S. Office of Management and Budget (OMB) Circular A-87 (2 CFR part 225). It is the judgment and determination of HHS/ACF that the "benefiting program" cost allocation methodology is the appropriate methodology for the proper use of Federal TANF funds. The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 gave federally-recognized Tribes the opportunity to operate their own Tribal TANF programs. Federally-recognized Indian tribes operating approved Tribal TANF programs have always followed the "benefiting program" cost allocation methodology in accordance with OMB Circular A-87 (2 CFR part 225) and the applicable regulatory provisions at 45 CFR 286.45(c) and (d). This final rule contains no substantive changes to the proposed rule published on September 27, 2006.

Changes in Determining Gifted Eligibility for Underrepresented Students. Research Note. Volume 0802

ERIC Educational Resources Information Center

Froman, Terry

2008-01-01

There are a number of detailed requirements for gifted screening, referral and eligibility specified under State Board Rules and School Board Rules. In all of these areas, explicit mention is made of the Florida Comprehensive Assessment Test (FCAT) Norm Referenced Test (NRT) scores as being integral components. Due to budget considerations, the…

Accountability with Voucher Threats, Responses, and the Test-Taking Population: Regression Discontinuity Evidence from Florida

ERIC Educational Resources Information Center

Chakrabarti, Rajashri

2013-01-01

Florida's 1999 A-plus program was a consequential accountability program that embedded vouchers in an accountability regime. Under Florida rules, scores of students in several special education (ESE) and limited English proficient (LEP) categories were not included in the computation of school grades. One might expect these rules to induce F…

The dead donor rule and the concept of death: severing the ties that bind them.

PubMed

Koppelman, Elysa R

2003-01-01

One goal of the transplant community is to seek ways to increase the number of people who are willing and able to donate organs. People in states between life and death are often medically excellent candidates for donating organs. Yet public policy surrounding organ procurement is a delicate matter. While there is the utilitarian goal of increasing organ supply, there is also the deontologic concern about respect for persons. Public policy must properly mediate between these two concerns. Currently the dead donor (dd) rule is appealed to as an attempt at such mediation. I argue that given the lack of consensus on a definition of death, the dd rule is no longer successful at mediating utilitarian and deontologic concerns. I suggest instead that focusing on a particular person's history can be successful.

Minimal state-dependent proof of measurement contextuality for a qubit

NASA Astrophysics Data System (ADS)

Kunjwal, Ravi; Ghosh, Sibasish

2014-04-01

We show that three unsharp binary qubit measurements are enough to violate a generalized noncontextuality inequality, the Liang-Spekkens-Wiseman inequality, in a state-dependent manner. For the case of trine spin axes we calculate the optimal quantum violation of this inequality. In addition, we show that unsharp qubit measurements do not allow a state-independent violation of this inequality. We thus provide a minimal state-dependent proof of measurement contextuality requiring one qubit and three unsharp measurements. Our result rules out generalized noncontextual models of these measurements which were previously conjectured to exist. More importantly, this class of generalized noncontextual models includes the traditional Kochen-Specker (KS) noncontextual models as a proper subset, so our result rules out a larger class of models than those ruled out by a violation of the corresponding KS inequality in this scenario.

Blowout Monitor

NASA Technical Reports Server (NTRS)

1994-01-01

C Language Integrated Production System (CLIPS), a NASA-developed software shell for developing expert systems, has been embedded in a PC-based expert system for training oil rig personnel in monitoring oil drilling. Oil drilling rigs if not properly maintained for possible blowouts pose hazards to human life, property and the environment may be destroyed. CLIPS is designed to permit the delivery of artificial intelligence on computer. A collection of rules is set up and, as facts become known, these rules are applied. In the Well Site Advisor, CLIPS provides the capability to accurately process, predict and interpret well data in a real time mode. CLIPS was provided to INTEQ by COSMIC.

[Response to US review rules on patent subject matter of traditional Chinese medicine compositions].

PubMed

Liu, Pan; Cao, Ya-di; Gong, Rui-Juan; Liu, Wei

2018-02-01

The United States Patent and Trademark Office(USPTO) issued Interim Guidance on Patent Subject Matter Eligibility on December 16， 2014， bringing certain effects to the review rules on patent application of Chinese medicine compositions. Based on the Interim Guidance， cases analysis was used in this paper to analyze the patent subject matter issues of traditional Chinese medicine compositions in the United States. The researches have shown that the application documents should be properly written in the United States when the patent for Chinese medicine compositions is applied， which can improve the probability of authorization. Copyright© by the Chinese Pharmaceutical Association.

Workplace Literacy: Ethical Issues through the Lens of Experience

ERIC Educational Resources Information Center

Folinsbee, Sue

2009-01-01

Even though principles to guide practice are crucial, there are no hard-and-fast rules for resolving ethical issues--dilemmas that are not easily resolvable because they present opposing values and outcomes that may harm to certain groups of people if not properly considered. This article describes a number of ethical dilemmas faced as a workplace…

26 CFR 1.103(n)-6T - Determinations of population (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

...(n)-6T Section 1.103(n)-6T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY....103(n)-6T Determinations of population (temporary). Q-1: What is the proper method for determining...(n)-6T: Example. County Q is located within State R. There are no constitutional home rule cities in...

Inland Waters Night Lighting Configurations: A Navigation Rules Course for Coast Guard Auxiliarists.

ERIC Educational Resources Information Center

Griffiths, Gregory Peter

A project developed a training program to teach boaters to recognize and interpret properly the lights of other vessels in nighttime or other reduced visibility conditions in the inland waters of the United States. The project followed the Instructional Systems Design model in the development of the course. The target population were members of…

Law Professors Rule Laptops out of Order in Class

ERIC Educational Resources Information Center

Foster, Andrea L.

2008-01-01

The forbidden-laptop zone is territory into which few professors dare tread. Students have been known to protest when laptops are banned from a classroom, and even claim that they are being denied a proper education. Professors who have taken the bold step, though, sound like they've experienced an epiphany. A professor at the University, Don…

75 FR 78172 - Fisheries of the Exclusive Economic Zone Off Alaska; Groundfish Retention Standard; Emergency Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... fish under the GRS may be offset by increased profitability because they are no longer operating in a... preamble). Using information from NMFS' catch accounting database and the methodology used in the Amendment... requirements must remain effective to ensure proper catch accounting under the Amendment 80 quota-based catch...

The Proper Sequence for Correcting Correlation Coefficients for Range Restriction and Unreliability.

ERIC Educational Resources Information Center

Stauffer, Joseph M.; Mendoza, Jorge L.

2001-01-01

Uses classical test theory to show that it is the nature of the range restriction, rather than the nature of the available reliability coefficient, that determines the sequence for applying corrections for range restriction and unreliability. Shows how the common rule of thumb for choosing the sequence is tenable only when the correction does not…

Law on the Forests of the DPRK [11 December 1992].

PubMed

1992-12-16

This 1992 law implements the state policy of the Democratic People's Republic of Korea on forests by establishing rules for the creation, management, and protection of all classes of forests and forest resources. The Law includes provisions on plans for the planting of trees, forest-fire prevention, soil erosion control, and proper management of commercial logging.

Second Language Learners' Divergence from Target Language Pragmatic Norms

ERIC Educational Resources Information Center

Gomez-Laich, Maria Pia

2016-01-01

Pragmatic competence is an indispensable aspect of language ability in order for second and foreign language (L2/FL) learners to understand and be understood in their interactions with both native and nonnative speakers of the target language. Without a proper understanding of the pragmatic rules in the target language, learners may run the risk…

29 CFR 102.22 - Extension of time for filing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Extension of time for filing. 102.22 Section 102.22 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure Under... of time for filing. Upon his own motion or upon proper cause shown by any other party the regional...

29 CFR 102.22 - Extension of time for filing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 2 2013-07-01 2013-07-01 false Extension of time for filing. 102.22 Section 102.22 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure Under... of time for filing. Upon his own motion or upon proper cause shown by any other party the regional...

29 CFR 102.22 - Extension of time for filing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 2 2012-07-01 2012-07-01 false Extension of time for filing. 102.22 Section 102.22 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure Under... of time for filing. Upon his own motion or upon proper cause shown by any other party the regional...

29 CFR 102.22 - Extension of time for filing.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 2 2014-07-01 2014-07-01 false Extension of time for filing. 102.22 Section 102.22 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure Under... of time for filing. Upon his own motion or upon proper cause shown by any other party the regional...

29 CFR 102.22 - Extension of time for filing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 2 2011-07-01 2011-07-01 false Extension of time for filing. 102.22 Section 102.22 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure Under... of time for filing. Upon his own motion or upon proper cause shown by any other party the regional...

76 FR 6533 - Airworthiness Directives; Hawker Beechcraft Corporation (Type Certificate Previously Held by...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

... (FAA), DOT. ACTION: Final rule. SUMMARY: We are adopting a new airworthiness directive (AD) for the products listed above. This AD requires a detailed inspection for proper sealant of the left and right... sealant on the left and right pylon firewall structures. We are issuing this AD to detect and correct...

A clinical decision rule to prioritize polysomnography in patients with suspected sleep apnea.

PubMed

Rodsutti, Julvit; Hensley, Michael; Thakkinstian, Ammarin; D'Este, Catherine; Attia, John

2004-06-15

To derive and validate a clinical decision rule that can help to prioritize patients who are on waiting lists for polysomnography, Prospective data collection on consecutive patients referred to a sleep center. The Newcastle Sleep Disorders Centre, University of Newcastle, NSW, Australia. Consecutive adult patients who had been scheduled for initial diagnostic polysomnography. Eight hundred and thirty-seven patients were used for derivation of the decision rule. An apnea-hypopnoea index of at least 5 was used as the cutoff point to diagnose sleep apnea. Fifteen clinical features were included in the analyses using logistic regression to construct a model from the derivation data set. Only 5 variables--age, sex, body mass index, snoring, and stopping breathing during sleep--were significantly associated with sleep apnea. A scoring scheme based on regression coefficients was developed, and the total score was trichotomized into low-, moderate-, and high-risk groups with prevalence of sleep apnea of 8%, 51%, and 82%, respectively. Color-coded tables were developed for ease of use. The clinical decision rule was validated on a separate set of 243 patients. Receiver operating characteristic analysis confirmed that the decision rule performed well, with the area under the curve being similar for both the derivation and validation sets: 0.81 and 0.79, P =.612. We conclude that this decision rule was able to accurately classify the risk of sleep apnea and will be useful for prioritizing patients with suspected sleep apnea who are on waiting lists for polysomnography.

PO-07 - Excluding pulmonary embolism in cancer patients using the Wells rule and age-adjusted D-dimer testing: an individual patient data meta-analysis.

PubMed

van Es, N; van der Hulle, T; van Es, J; den Exter, P L; Douma, R A; Goekoop, R J; Mos, I C M; Garcia, J G; Kamphuisen, P W; Huisman, M V; Klok, F A; Büller, H R; Bossuyt, P M

2016-04-01

Among patients with clinically suspected pulmonary embolism (PE), imaging and anticoagulant treatment can be safely withheld in approximately one-third of patients based on the combination of a "PE unlikely" Wells score and a D-dimer below the age-adjusted threshold. The clinical utility of this diagnostic approach in cancer patients is less clear. To evaluate the efficiency and failure rate of the original and simplified Wells rules in combination with age-adjusted D-dimer testing in patients with active cancer. Individual patient data were used from 6 large prospective studies in which the diagnostic management of PE was guided by the original Wells rule and D-dimer testing. Study physicians classified patients as having active cancer if they had new, recurrent, or progressive cancer (excluding basal-cell or squamous-cell skin carcinoma), or cancer requiring treatment in the last 6 months. We evaluated the dichotomous Wells rule and its simplified version (Table). The efficiency of the algorithm was defined as the proportion of patients with a "PE unlikely" Wells score and a negative age-adjusted D-dimer, defined by a D-dimer below the threshold of a patient's age times 10 μg/L in patients aged ≥51 years. A diagnostic failure was defined as a patient with a "PE unlikely" Wells score and negative age-adjusted D-dimer who had symptomatic venous thromboembolism during 3 months follow-up. A one-stage random effects meta-analysis was performed to estimate the efficiency and failure. The dataset comprised 938 patients with active cancer with a mean age of 63 years. The most frequent cancer types were breast (13%), gastrointestinal tract (11%), and lung (8%). The type of cancer was not specified in 42%. The pooled PE prevalence was 29% (95% CI 25-32). PE could be excluded in 122 patients based on a "PE unlikely" Wells score and a negative age-adjusted D-dimer (efficiency 13%; 95% CI 11-15). Two of 122 patients were diagnosed with non-fatal symptomatic venous thromboembolism during follow-up (failure rate 1.5%; 95% CI 0.13-14.8). The simplified Wells score in combination with a negative age-adjusted D-dimer had an efficiency of 3.9% (95% CI 2.0-7.6) and a failure rate of 2.4% (95% CI 0.3-15). Among cancer patients with clinically suspected PE, imaging and anticoagulant treatment can be withheld in 1 out of every 8 patients by the original Wells rule and age-adjusted D-dimer testing. The simplified Wells rule was neither efficient nor safe in this population. © 2016 Elsevier Ltd. All rights reserved.

Integration of Distributed Services and Hybrid Models Based on Process Choreography to Predict and Detect Type 2 Diabetes

PubMed Central

Bayo-Monton, Jose-Luis; Argente-Pla, María; Fernandez-Llatas, Carlos; Merino-Torres, Juan Francisco

2017-01-01

Life expectancy is increasing and, so, the years that patients have to live with chronic diseases and co-morbidities. Type 2 diabetes is one of the most prevalent chronic diseases, specifically linked to being overweight and ages over sixty. Recent studies have demonstrated the effectiveness of new strategies to delay and even prevent the onset of type 2 diabetes by a combination of active and healthy lifestyle on cohorts of mid to high risk subjects. Prospective research has been driven on large groups of the population to build risk scores that aim to obtain a rule for the classification of patients according to the odds for developing the disease. Currently, there are more than two hundred models and risk scores for doing this, but a few have been properly evaluated in external groups and integrated into a clinical application for decision support. In this paper, we present a novel system architecture based on service choreography and hybrid modeling, which enables a distributed integration of clinical databases, statistical and mathematical engines and web interfaces to be deployed in a clinical setting. The system was assessed during an eight-week continuous period with eight endocrinologists of a hospital who evaluated up to 8080 patients with seven different type 2 diabetes risk models implemented in two mathematical engines. Throughput was assessed as a matter of technical key performance indicators, confirming the reliability and efficiency of the proposed architecture to integrate hybrid artificial intelligence tools into daily clinical routine to identify high risk subjects. PMID:29286314

Integration of Distributed Services and Hybrid Models Based on Process Choreography to Predict and Detect Type 2 Diabetes.

PubMed

Martinez-Millana, Antonio; Bayo-Monton, Jose-Luis; Argente-Pla, María; Fernandez-Llatas, Carlos; Merino-Torres, Juan Francisco; Traver-Salcedo, Vicente

2017-12-29

Life expectancy is increasing and, so, the years that patients have to live with chronic diseases and co-morbidities. Type 2 diabetes is one of the most prevalent chronic diseases, specifically linked to being overweight and ages over sixty. Recent studies have demonstrated the effectiveness of new strategies to delay and even prevent the onset of type 2 diabetes by a combination of active and healthy lifestyle on cohorts of mid to high risk subjects. Prospective research has been driven on large groups of the population to build risk scores that aim to obtain a rule for the classification of patients according to the odds for developing the disease. Currently, there are more than two hundred models and risk scores for doing this, but a few have been properly evaluated in external groups and integrated into a clinical application for decision support. In this paper, we present a novel system architecture based on service choreography and hybrid modeling, which enables a distributed integration of clinical databases, statistical and mathematical engines and web interfaces to be deployed in a clinical setting. The system was assessed during an eight-week continuous period with eight endocrinologists of a hospital who evaluated up to 8080 patients with seven different type 2 diabetes risk models implemented in two mathematical engines. Throughput was assessed as a matter of technical key performance indicators, confirming the reliability and efficiency of the proposed architecture to integrate hybrid artificial intelligence tools into daily clinical routine to identify high risk subjects.

A probabilistic verification score for contours demonstrated with idealized ice-edge forecasts

NASA Astrophysics Data System (ADS)

Goessling, Helge; Jung, Thomas

2017-04-01

We introduce a probabilistic verification score for ensemble-based forecasts of contours: the Spatial Probability Score (SPS). Defined as the spatial integral of local (Half) Brier Scores, the SPS can be considered the spatial analog of the Continuous Ranked Probability Score (CRPS). Applying the SPS to idealized seasonal ensemble forecasts of the Arctic sea-ice edge in a global coupled climate model, we demonstrate that the SPS responds properly to ensemble size, bias, and spread. When applied to individual forecasts or ensemble means (or quantiles), the SPS is reduced to the 'volume' of mismatch, in case of the ice edge corresponding to the Integrated Ice Edge Error (IIEE).

Affect-Aware Adaptive Tutoring Based on Human-Automation Etiquette Strategies.

PubMed

Yang, Euijung; Dorneich, Michael C

2018-06-01

We investigated adapting the interaction style of intelligent tutoring system (ITS) feedback based on human-automation etiquette strategies. Most ITSs adapt the content difficulty level, adapt the feedback timing, or provide extra content when they detect cognitive or affective decrements. Our previous work demonstrated that changing the interaction style via different feedback etiquette strategies has differential effects on students' motivation, confidence, satisfaction, and performance. The best etiquette strategy was also determined by user frustration. Based on these findings, a rule set was developed that systemically selected the proper etiquette strategy to address one of four learning factors (motivation, confidence, satisfaction, and performance) under two different levels of user frustration. We explored whether etiquette strategy selection based on this rule set (systematic) or random changes in etiquette strategy for a given level of frustration affected the four learning factors. Participants solved mathematics problems under different frustration conditions with feedback that adapted dynamic changes in etiquette strategies either systematically or randomly. The results demonstrated that feedback with etiquette strategies chosen systematically via the rule set could selectively target and improve motivation, confidence, satisfaction, and performance more than changing etiquette strategies randomly. The systematic adaptation was effective no matter the level of frustration for the participant. If computer tutors can vary the interaction style to effectively mitigate negative emotions, then ITS designers would have one more mechanism in which to design affect-aware adaptations that provide the proper responses in situations where human emotions affect the ability to learn.

Detecting a proper patient with a help of medical data retrieval

NASA Astrophysics Data System (ADS)

Malecka-Massalska, Teresa; Maciejewski, Ryszard; Wasiewicz, Piotr; Zaluska, Wojciech; Ksiazek, Andrzej

2009-06-01

Electric bioimpedance is one of methods to assess the hydrate status in hemodialyzed patients. It is also being used for assessing the hydration level among peritoneal dialysed patients, diagnosed with neoplastic diseases, patients after organ transplantations and the ones infected with HIV virus. During measurements sets were obtained from two groups, which were named a control (healthy volunteers) and test group (hemodialyzed patients). Zscored, discretized data and data retrieval results were computed in R language environment in order to find a simple rule for recognizing health problems. The executed experiments affirm possibilities of creating good classifiers for detecting a proper patient with the help of medical data sets, but only with previous training.

Evidential Value That Exercise Improves BMI z-Score in Overweight and Obese Children and Adolescents

PubMed Central

Kelley, George A.; Kelley, Kristi S.

2015-01-01

Background. Given the cardiovascular disease (CVD) related importance of understanding the true effects of exercise on adiposity in overweight and obese children and adolescents, this study examined whether there is evidential value to rule out excessive and inappropriate reporting of statistically significant results, a major problem in the published literature, with respect to exercise-induced improvements in BMI z-score among overweight and obese children and adolescents. Methods. Using data from a previous meta-analysis of 10 published studies that included 835 overweight and obese children and adolescents, a novel, recently developed approach (p-curve) was used to test for evidential value and rule out selective reporting of findings. Chi-squared tests (χ 2) were used to test for statistical significance with alpha (p) values <0.05 considered statistically significant. Results. Six of 10 findings (60%) were statistically significant. Statistically significant right-skew to rule out selective reporting was found (χ 2 = 38.8, p = 0.0001). Conversely, studies neither lacked evidential value (χ 2 = 6.8, p = 0.87) nor lacked evidential value and were intensely p-hacked (χ 2 = 4.3, p = 0.98). Conclusion. Evidential value results confirm that exercise reduces BMI z-score in overweight and obese children and adolescents, an important therapeutic strategy for treating and preventing CVD. PMID:26509145

Evidential Value That Exercise Improves BMI z-Score in Overweight and Obese Children and Adolescents.

PubMed

Kelley, George A; Kelley, Kristi S

2015-01-01

Background. Given the cardiovascular disease (CVD) related importance of understanding the true effects of exercise on adiposity in overweight and obese children and adolescents, this study examined whether there is evidential value to rule out excessive and inappropriate reporting of statistically significant results, a major problem in the published literature, with respect to exercise-induced improvements in BMI z-score among overweight and obese children and adolescents. Methods. Using data from a previous meta-analysis of 10 published studies that included 835 overweight and obese children and adolescents, a novel, recently developed approach (p-curve) was used to test for evidential value and rule out selective reporting of findings. Chi-squared tests (χ (2)) were used to test for statistical significance with alpha (p) values <0.05 considered statistically significant. Results. Six of 10 findings (60%) were statistically significant. Statistically significant right-skew to rule out selective reporting was found (χ (2) = 38.8, p = 0.0001). Conversely, studies neither lacked evidential value (χ (2) = 6.8, p = 0.87) nor lacked evidential value and were intensely p-hacked (χ (2) = 4.3, p = 0.98). Conclusion. Evidential value results confirm that exercise reduces BMI z-score in overweight and obese children and adolescents, an important therapeutic strategy for treating and preventing CVD.

Scoring Tools for the Analysis of Infant Respiratory Inductive Plethysmography Signals.

PubMed

Robles-Rubio, Carlos Alejandro; Bertolizio, Gianluca; Brown, Karen A; Kearney, Robert E

2015-01-01

Infants recovering from anesthesia are at risk of life threatening Postoperative Apnea (POA). POA events are rare, and so the study of POA requires the analysis of long cardiorespiratory records. Manual scoring is the preferred method of analysis for these data, but it is limited by low intra- and inter-scorer repeatability. Furthermore, recommended scoring rules do not provide a comprehensive description of the respiratory patterns. This work describes a set of manual scoring tools that address these limitations. These tools include: (i) a set of definitions and scoring rules for 6 mutually exclusive, unique patterns that fully characterize infant respiratory inductive plethysmography (RIP) signals; (ii) RIPScore, a graphical, manual scoring software to apply these rules to infant data; (iii) a library of data segments representing each of the 6 patterns; (iv) a fully automated, interactive formal training protocol to standardize the analysis and establish intra- and inter-scorer repeatability; and (v) a quality control method to monitor scorer ongoing performance over time. To evaluate these tools, three scorers from varied backgrounds were recruited and trained to reach a performance level similar to that of an expert. These scorers used RIPScore to analyze data from infants at risk of POA in two separate, independent instances. Scorers performed with high accuracy and consistency, analyzed data efficiently, had very good intra- and inter-scorer repeatability, and exhibited only minor confusion between patterns. These results indicate that our tools represent an excellent method for the analysis of respiratory patterns in long data records. Although the tools were developed for the study of POA, their use extends to any study of respiratory patterns using RIP (e.g., sleep apnea, extubation readiness). Moreover, by establishing and monitoring scorer repeatability, our tools enable the analysis of large data sets by multiple scorers, which is essential for longitudinal and multicenter studies.

The Visual Scoring of Sleep in Infants 0 to 2 Months of Age.

PubMed

Grigg-Damberger, Madeleine M

2016-03-01

In March 2014, the American Academy of Sleep Medicine (AASM) Board of Directors requested the Scoring Manual Editorial Board develop rules, terminology, and technical specifications for scoring sleep/wake states in full-term infants from birth to 2 mo of age, cognizant of the 1971 Anders, Emde, and Parmelee Manual for Scoring Sleep in Newborns. On July 1, 2015, the AASM published rules for scoring sleep in infants, ages 0-2 mo. This evidence-based review summarizes the background information provided to the Scoring Manual Editorial Board to write these rules. The Anders Manual only provided criteria for coding physiological and behavioral state characteristics in polysomnograms (PSG) of infants, leaving specific sleep scoring criteria to the individual investigator. Other infant scoring criteria have been published, none widely accepted or used. The AASM Scoring Manual infant scoring criteria incorporate modern concepts, digital PSG recording techniques, practicalities, and compromises. Important tenets are: (1) sleep/wake should be scored in 30-sec epochs as either wakefulness (W), rapid eye movement, REM (R), nonrapid eye movement, NREM (N) and transitional (T) sleep; (2) an electroencephalographic (EEG) montage that permits adequate display of young infant EEG is: F3-M2, F4-M1, C3-M2, C4-M1, O1-M2, O2-M1; additionally, recording C3-Cz, Cz-C4 help detect early and asynchronous sleep spindles; (3) sleep onsets are more often R sleep until 2-3 mo postterm; (4) drowsiness is best characterized by visual observation (supplemented by later video review); (5) wide open eyes is the most crucial determinant of W; (6) regularity (or irregularity) of respiration is the single most useful PSG characteristic for scoring sleep stages at this age; (7) trace alternant (TA) is the only relatively distinctive EEG pattern, characteristic of N sleep, and usually disappears by 1 mo postterm replaced by high voltage slow (HVS); (8) sleep spindles first appear 44-48 w conceptional age (CA) and when present prompt scoring N; (9) score EEG activity in an epoch as "continuous" or "discontinuous" for inter-scorer reliability; (10) score R if four or more of the following conditions are present, including irregular respiration and rapid eye movement(s): (a) low chin EMG (for the majority of the epoch); (b) eyes closed with at least one rapid eye movement (concurrent with low chin tone); (c) irregular respiration; (d) mouthing, sucking, twitches, or brief head movements; and (e) EEG exhibits a continuous pattern without sleep spindles; (11) because rapid eye movements may not be seen on every page, epochs following an epoch of definite R in the absence of rapid eye movements may be scored if the EEG is continuous without TA or sleep spindles, chin muscle tone low for the majority of the epoch; and there is no intervening arousal; (12) Score N if four or more of the following conditions are present, including regular respiration, for the majority of the epoch: (a) eyes are closed with no eye movements; (b) chin EMG tone present; (c) regular respiration; and (d) EEG patterns of either TA, HVS, or sleep spindles are present; and (13) score T sleep if an epoch contains two or more discordant PSG state characteristics (either three NREM and two REM characteristics or two NREM and three REM characteristics). These criteria for ages 0-2 mo represent far more than baby steps. Like all the other AASM Manual rules and specifications none are fixed in stone, all open for debate, discussion and revision with the fundamental goal to provide standards for comparison of methods and results. A commentary on this article appears in this issue on page 291. © 2016 American Academy of Sleep Medicine.

Validation of the Oudega diagnostic decision rule for diagnosing deep vein thrombosis in frail older out-of-hospital patients.

PubMed

Schouten, Henrike J; Koek, Huiberdina L; Oudega, Ruud; van Delden, Johannes J M; Moons, Karel G M; Geersing, Geert-Jan

2015-02-01

We aimed to validate the Oudega diagnostic decision rule-which was developed and validated among younger aged primary care patients-to rule-out deep vein thrombosis (DVT) in frail older outpatients. In older patients (>60 years, either community dwelling or residing in nursing homes) with clinically suspected DVT, physicians recorded the score on the Oudega rule and d-dimer test. DVT was confirmed with a composite reference standard including ultrasonography examination and 3-month follow-up. The proportion of patients with a very low probability of DVT according to the Oudega rule (efficiency), and the proportion of patients with symptomatic venous thromboembolism during 3 months follow-up within this 'very low risk' group (failure rate) was calculated. DVT occurred in 164 (47%) of the 348 study participants (mean age 81 years, 85% residing in nursing homes). The probability of DVT was very low in 69 patients (Oudega score ≤3 points plus a normal d-dimer test; efficiency 20%) of whom four had non-fatal DVT (failure rate 5.8%; 2.3-14%). With a simple revised version of the Oudega rule for older suspected patients, 43 patients had a low risk of DVT (12% of the total population) of whom only one had DVT (failure rate 2.3%; 0.4-12%). In older suspected patients, application of the original Oudega rule to exclude DVT resulted in a higher failure rate as compared to previous studies. A revised and simplified Oudega strategy specifically developed for elderly suspected patients resulted in a lower failure rate though at the expense of a lower efficiency. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Geriatric Fever Score: a new decision rule for geriatric care.

PubMed

Chung, Min-Hsien; Huang, Chien-Cheng; Vong, Si-Chon; Yang, Tzu-Meng; Chen, Kuo-Tai; Lin, Hung-Jung; Chen, Jiann-Hwa; Su, Shih-Bin; Guo, How-Ran; Hsu, Chien-Chin

2014-01-01

Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups. Consecutive geriatric patients (≥65 years old) visiting the emergency department (ED) of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done. Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3), Severe coma (GCS ≤ 8), and Thrombocytopenia (platelets <150 10(3)/mm3) (LST). After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0%) (95% CI: 2.3-6.9%): a general ward or treatment in the ED then discharge and high (30.3%) (95% CI: 17.4-47.3%): consider the intensive care unit. The area under the curve for the rule was 0.73. We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care? A psychometric study

PubMed Central

2014-01-01

Background Anxiety scales may help primary care physicians to detect specific anxiety disorders among the many emotionally distressed patients presenting in primary care. The anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) consists of an admixture of symptoms of specific anxiety disorders. The research questions were: (1) Is the anxiety scale unidimensional or multidimensional? (2) To what extent does the anxiety scale detect specific DSM-IV anxiety disorders? (3) Which cut-off points are suitable to rule out or to rule in (which) anxiety disorders? Methods We analyzed 5 primary care datasets with standardized psychiatric diagnoses and 4DSQ scores. Unidimensionality was assessed through confirmatory factor analysis (CFA). We examined mean scores and anxiety score distributions per disorder. Receiver operating characteristic (ROC) analysis was used to determine optimal cut-off points. Results Total n was 969. CFA supported unidimensionality. The anxiety scale performed slightly better in detecting patients with panic disorder, agoraphobia, social phobia, obsessive compulsive disorder (OCD) and post traumatic stress disorder (PTSD) than patients with generalized anxiety disorder (GAD) and specific phobia. ROC-analysis suggested that ≥4 was the optimal cut-off point to rule out and ≥10 the cut-off point to rule in anxiety disorders. Conclusions The 4DSQ anxiety scale measures a common trait of pathological anxiety that is characteristic of anxiety disorders, in particular panic disorder, agoraphobia, social phobia, OCD and PTSD. The anxiety score detects the latter anxiety disorders to a slightly greater extent than GAD and specific phobia, without being able to distinguish between the different anxiety disorder types. The cut-off points ≥4 and ≥10 can be used to separate distressed patients in three groups with a relatively low, moderate and high probability of having one or more anxiety disorders. PMID:24761829

Cancer Rehabilitation: Do Functional Gains Relate to 60 Percent Rule Classification or to the Presence of Metastasis?

PubMed

Sliwa, James A; Shahpar, Samman; Huang, Mark E; Spill, Gayle; Semik, Patrick

2016-02-01

Literature supporting the benefits of inpatient rehabilitation for cancer patients is increasing. Many cancer patients, however, do not qualify for inclusion in the Centers for Medicare and Medicaid 60% rule and consequently may not receive services. The benefit of inpatient rehabilitation in this specific cancer group has not been investigated and is the focus of this study. To investigate functional gains made during inpatient rehabilitation by patients impaired by cancer, and to compare the functional gains made during inpatient rehabilitation for patients impaired by cancer in relation to the presence or absence of metastatic disease and compliance or noncompliance with the Medicare 60% rule. Freestanding university-affiliated rehabilitation hospital. A total of 176 adult patients admitted for inpatient rehabilitation due to cancer. Retrospective chart review of patients admitted for inpatient rehabilitation with deficits identified related to cancer. Demographic data including cancer type, presence of metastasis, age, gender, marital status, ethnicity, length of stay (LOS), discharge destination, and transfer to acute care. Functional status including admission and discharge Functional Independence Measure Score (FIM), total, motor, and cognitive FIM gains, total, motor, and cognitive FIM efficiency for the study sample, for patients with and without a diagnosis compliant with the 60% rule and for patients with and without metastatic disease. In all, 176 cases met inclusion criteria. An admission coded diagnosis that was compliant with the 60% rule was present in 97 cases (55.1%). In 153 cases, the presence or absence of metastatic disease was known. Metastatic disease was present in 69 cases (45%). All groups (total sample, metastatic versus nonmetastatic, compliant versus noncompliant) made significant functional gains. Patients with a diagnosis noncompliant with the 60% rule had higher admission total FIM (P = .001), discharge total FIM (P = .014), admission motor FIM (P = .005), admission cognitive FIM (P = .008), and discharge cognitive FIM (P < .001) scores than those with a compliant diagnosis. Patients with metastatic disease had higher admission total FIM (P = .026) and admission (P = .001) and discharge (P = .02) cognitive FIM scores than patients with nonmetastatic disease. There were no significant differences between groups regarding total, motor, or cognitive FIM gains or total motor or cognitive FIM efficiencies. Differences in age, length of stay, and admission motor and discharge FIM scores between groups were related to cancer types and source of impairment. Patients with functional limitations resulting from cancer or its treatment made significant functional gains in inpatient rehabilitation. There were no significant differences in functional gains made by those with or without metastatic disease or those compliant versus noncompliant with the 60% rule. The presence of metastatic disease or a diagnosis not compliant with the 60% rule does not preclude cancer patients from making significant functional gains. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

The American Academy of Sleep Medicine Inter-scorer Reliability Program: Sleep Stage Scoring

PubMed Central

Rosenberg, Richard S.; Van Hout, Steven

2013-01-01

Study Objectives: The program provides a unique opportunity to compare a large number of scorers with varied levels of experience to determine sleep stage scoring agreement. The objective is to examine areas of disagreement to inform future revisions of the AASM Manual for the Scoring of Sleep and Associated Events. Methods: The sample included 9 record fragments, 1,800 epochs and more than 3,200,000 scoring decisions. More than 2,500 scorers, most with 3 or more years of experience, participated. The analysis determined agreement with the score chosen by the majority of scorers. Results: Sleep stage agreement averaged 82.6%. Agreement was highest for stage R sleep with stages N2 and W approaching the same level. Scoring agreement for stage N3 sleep was 67.4% and was lowest for stage N1 at 63.0%. Scorers had particular difficulty with the last epoch of stage W before sleep onset, the first epoch of stage N2 after stage N1 and the first epoch of stage R after stage N2. Discrimination between stages N2 and N3 was particularly difficult for scorers. Conclusions: These findings suggest that with current rules, inter-scorer agreement in a large group is approximately 83%, a level similar to that reported for agreement between expert scorers. Agreement in the scoring of stages N1 and N3 sleep was low. Modifications to the scoring rules to improve scoring during sleep stage transitions may result in improvement. Commentary: A commentary on this article appears in this issue on page 89. Citation: Rosenberg RS; Van Hout S. The American Academy of Sleep Medicine inter-scorer reliability program: sleep stage scoring. J Clin Sleep Med 2013;9(1):81–87. PMID:23319910

Surface stability and the selection rules of substrate orientation for optimal growth of epitaxial II-VI semiconductors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yin, Wan-Jian; Department of Physics & Astronomy, and Wright Center for Photovoltaics Innovation and Commercialization, The University of Toledo, Toledo, Ohio 43606; Yang, Ji-Hui

2015-10-05

The surface structures of ionic zinc-blende CdTe (001), (110), (111), and (211) surfaces are systematically studied by first-principles density functional calculations. Based on the surface structures and surface energies, we identify the detrimental twinning appearing in molecular beam epitaxy (MBE) growth of II-VI compounds as the (111) lamellar twin boundaries. To avoid the appearance of twinning in MBE growth, we propose the following selection rules for choosing optimal substrate orientations: (1) the surface should be nonpolar so that there is no large surface reconstructions that could act as a nucleation center and promote the formation of twins; (2) the surfacemore » structure should have low symmetry so that there are no multiple equivalent directions for growth. These straightforward rules, in consistent with experimental observations, provide guidelines for selecting proper substrates for high-quality MBE growth of II-VI compounds.« less

A cybernetic theory of morality and moral autonomy.

PubMed

Chambers, J

2001-04-01

Human morality may be thought of as a negative feedback control system in which moral rules are reference values, and moral disapproval, blame, and punishment are forms of negative feedback given for violations of the moral rules. In such a system, if moral agents held each other accountable, moral norms would be enforced effectively. However, even a properly functioning social negative feedback system could not explain acts in which individual agents uphold moral rules in the face of contrary social pressure. Dr. Frances Kelsey, who withheld FDA approval for thalidomide against intense social pressure, is an example of the degree of individual moral autonomy possible in a hostile environment. Such extreme moral autonomy is possible only if there is internal, psychological negative feedback, in addition to external, social feedback. Such a cybernetic model of morality and moral autonomy is consistent with certain aspects of classical ethical theories.

Understanding Language Use in the Classroom: A Linguistic Guide for College Educators

ERIC Educational Resources Information Center

Behrens, Susan J.

2014-01-01

It is clear that a proper understanding of what academic English is and how to use it is crucial for success in college, and yet students face multiple obstacles in acquiring this new "code", not least that their professors often cannot agree amongst themselves on a definition and a set of rules. "Understanding Language Use in the…

Fusing Horizons -- A Grammatical Design Approach for the Arts and Humanities: Using Rules, Contingency and Hermeneutics in Design Education

ERIC Educational Resources Information Center

Bruton, Dean

2007-01-01

This article argues that grammatical thinking within a framework of phenomenological hermeneutics assists designing and may properly be used as a fundamental teaching approach for an interdisciplinary art and design studio. Furthermore, it argues that the theme of grammatical design awareness could be considered as a generic issue across all…

Proper Edging and Trimming Will Help Improve Lumber Value

Treesearch

Philip A. Araman

1991-01-01

Decisions on where to edge and trim waning edged boards, or to trim other boards, can have a major effect on the performance of a sawmill. Optimum decisions are difficult for a number of reasons, including: complexity of grading rules; operator skills; operator fatigue or lack of interest at times; and, the inability of operators to include lumber prices in decisions....

75 FR 9753 - Airworthiness Directives; Hawker Beechcraft Corporation (Type Certificate Previously Held by...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... Transportation (DOT). ACTION: Final rule. SUMMARY: We are adopting a new airworthiness directive (AD) for certain... you to do an operational check of the left and right pitot heat annunciators for proper operation and...

[Hygienic risks in swimming pool: knowledge and behaviours of consumers of three structures in Crema, Parma and Naples].

PubMed

Liguori, G; Castaldi, S; Signorelli, C; Auxilia, F; Alfano, V; Saccani, E; Visciano, A; Fanti, M; Spinelli, A; Pasquarella, C

2007-01-01

The swimmers health's protection and the maintenance of good safety standards of structures can be guaranteed under observance of rules and the well management of the structures and activities. An anonymous questionnaire, with 38 items, was used in order to analyse and better understand the knowledge and behaviour of the users of three swimming pools in Crema, Naples and Parma. Socio-demographic features were similar in the three centres. One of the most important result was that the necessity of showers and foot-bath before entering the swimming pool is not well understood (77% and 78% respectively); caps and foot bath are, instead, almost always worn (98% and 97%). Knowledge on infection diseases transmitted by water is very poor, warts and mycosis being the best known. Sport structures are places where health and wellness can be affected. It is important to underline the role of behavioural rules as the use of showers, caps, and proper shoes. Authors recognize the swimming pool regulations as a valid tool for health promotion. It must be clear and easily understood and it has to be linked to a proper education pathway of all users and employees.

How Do Observational Scales Correlate the Ratings of Children's Behavior during Pediatric Procedural Sedation?

PubMed Central

Moura, Larissa da Silva

2016-01-01

Background. There is little information regarding the ability of observational scales to properly assess children's behavior during procedural sedation. Aim. To evaluate the characteristics of the Houpt scales, the Ohio State University Behavioral Rating Scale (OSUBRS) and the Venham Behavior Rating Scale when applied to preschool children undergoing conscious dental sedation. Design. This study included 27 children, 4–6 years old with early childhood caries that participated in a clinical trial (NCT02284204) that investigated two sedative regimes using oral midazolam/ketamine. Dental appointments were video-recorded; five calibrated observers assessed 1,209 minutes of video recording to score the children's behavior, following the instructions of the investigated scales. Data were analyzed by descriptive analysis and Spearman correlation tests (P < 0.05). Results. The Houpt overall behavior and the Venham scale were highly correlated (rho = −0.87; P < 0.001). OSUBRS scores were better correlated with Houpt overall behavior and Venham ratings, when compared to Houpt scores in the categories for movement and crying. Conclusions. The Houpt overall behavior and the Venham scores are global scales that properly measure children's behavior during dental sedation. Continuous assessment with OSUBRS through videos has a chance to give more precise data, while the Houpt categories can easily demonstrate children's behavior during procedures. PMID:28116299

Rule-based mapping of fire-adapted vegetation and fire regimes for the Monongahela National Forest

Treesearch

Melissa A. Thomas-Van Gundy; Gregory J. Nowacki; Thomas M. Schuler

2007-01-01

A rule-based approach was employed in GIS to map fire-adapted vegetation and fire regimes within the proclamation boundary of the Monongahela National Forest. Spatial analyses and maps were generated using ArcMap 9.1. The resulting fireadaptation scores were then categorized into standard fire regime groups. Fire regime group V (200+ yrs) was the most common, assigned...

The Golden Rule

ERIC Educational Resources Information Center

Lustig, Susan

2008-01-01

While some Olympic results don't leave room for argument, scoring other events such as gymnastics, is subjective. So much so that in 2006, the "Code of Points" and the entire scoring system were overhauled. It is the same with school design. One might think it would be nice to have a "Code of Points," so that every education institution could…

D mesons in a magnetic field

DOE PAGES

Gubler, Philipp; Hattori, Koichi; Lee, Su Houng; ...

2016-03-15

In this paper, we investigate the mass spectra of open heavy flavor mesons in an external constant magnetic field within QCD sum rules. Spectral Ansatze on the phenomenological side are proposed in order to properly take into account mixing effects between the pseudoscalar and vector channels, and the Landau levels of charged mesons. The operator product expansion is implemented up to dimension-5 operators. As a result, we find for neutral D mesons a significant positive mass shift that goes beyond simple mixing effects. In contrast, charged D mesons are further subject to Landau level effects, which together with the mixingmore » effects almost completely saturate the mass shifts obtained in our sum rule analysis.« less

The Peptic Ulcer Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation. A cohort study.

PubMed

Møller, M H; Engebjerg, M C; Adamsen, S; Bendix, J; Thomsen, R W

2012-05-01

Accurate and early identification of high-risk surgical patients with perforated peptic ulcer (PPU) is important for triage and risk stratification. The objective of the present study was to develop a new and improved clinical rule to predict mortality in patients following surgical treatment for PPU. nationwide cohort study based on prospectively collected data. thirty-five hospitals in Denmark. a total of 2668 patients surgically treated for gastric or duodenal PPU between 1 February 2003 and 31 August 2009. 30-day mortality. We derived a new clinical prediction rule for 30-day mortality and evaluated and compared its prognostic performance with the American Society of Anaesthesiologists (ASA) and Boey scores. A total of 708 patients (27%) died within 30 days of surgery. The Peptic Ulcer Perforation (PULP) score - comprised eight variables with an adjusted odds ratio of more than 1.28: 1) age > 65 years, 2) active malignant disease or AIDS, 3) liver cirrhosis, 4) steroid use, 5) time from perforation to admission > 24 h, 6) pre-operative shock, 7) serum creatinine > 130 μM, and 8) the four levels of the ASA score (from 2 to 5). The score predicted mortality well (area under receiver operating characteristics curve (AUC) 0.83). It performed considerably better than the Boey score (AUC 0.70) and better than the ASA score alone (AUC 0.78). The PULP score accurately predicts 30-day mortality in patients operated for PPU and can assist in risk stratification and triage. © 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

Clinical Characteristics of Proper Robot-Assisted Gait Training Group in Non-ambulatory Subacute Stroke Patients

PubMed Central

Kim, Soo Jeong; Lee, Hye Jin; Hwang, Seung Won; Pyo, Hannah; Yang, Sung Phil; Lim, Mun-Hee; Park, Gyu Lee

2016-01-01

Objective To identify the clinical characteristics of proper robot-assisted gait training group using exoskeletal locomotor devices in non-ambulatory subacute stroke patients. Methods A total of 38 stroke patients were enrolled in a 4-week robotic training protocol (2 sessions/day, 5 times/week). All subjects were evaluated for their general characteristics, Functional Ambulatory Classification (FAC), Fugl-Meyer Scale (FMS), Berg Balance Scale (BBS), Modified Rankin Scale (MRS), Modified Barthel Index (MBI), and Mini-Mental Status Examination (MMSE) at 0, 2, and 4 weeks. Statistical analysis were performed to determine significant clinical characteristics for improvement of gait function after robot-assisted gait training. Results Paired t-test showed that all functional parameters except MMSE were improved significantly (p<0.05). The duration of disease and baseline BBS score were significantly (p<0.05) correlated with FAC score in multiple regression models. Receiver operating characteristic (ROC) curve showed that a baseline BBS score of '9' was a cutoff value (AUC, 0.966; sensitivity, 91%–100%; specificity, 85%). By repeated-measures ANOVA, the differences in improved walking ability according to time were significant between group of patients who had baseline BBS score of '9' and those who did not have baseline BBS score of '9' Conclusion Our results showed that a baseline BBS score above '9' and a short duration of disease were highly correlated with improved walking ability after robot-assisted gait training. Therefore, baseline BBS and duration of disease should be considered clinically for gaining walking ability in robot-assisted training group. PMID:27152266

Knowledge and awareness of Consumer Protection Act among private dentists in Tricity, Punjab.

PubMed

Gambhir, Ramandeep Singh; Dhaliwal, Jagjit Singh; Anand, Samir; Bhardwaj, Arvind

2015-01-01

Consumer Protection Act (CPA) aims to protect the interests of the patients in case of any unethical treatment rendered by a medical or a dental health professional. The present study was conducted to assess knowledge and awareness of CPA among dental professionals in a Tricity in India. A cross-sectional study was conducted among 265 private dental practitioners in Tricity. A close-ended self-structured questionnaire was administered which contained 15 questions on knowledge and awareness regarding CPA. Categorization of knowledge scores was done at three levels-low, medium and high. Statistical analysis was done using ANOVA and Student t-test. 54.7% (145) of subjects were having low knowledge scores, 23.3% (62) had a medium score and 21.8% (58) had a high score. Mean knowledge score according to educational level was statistically significant (P<0.05), whereas there was no significant difference in case of gender and type of practice (P > 0.05). The results of the present study showed that majority of the subjects were aware of the existence of CPA but knowledge regarding basic rules and regulations was lacking in few studies. Therefore, dental professionals need to keep them updated of various rules and latest amendments to save themselves from any litigation.

End-of-life decisions and the reinvented Rule of Double Effect: a critical analysis.

PubMed

Lindblad, Anna; Lynöe, Niels; Juth, Niklas

2014-09-01

The Rule of Double Effect (RDE) holds that it may be permissible to harm an individual while acting for the sake of a proportionate good, given that the harm is not an intended means to the good but merely a foreseen side-effect. Although frequently used in medical ethical reasoning, the rule has been repeatedly questioned in the past few decades. However, Daniel Sulmasy, a proponent who has done a lot of work lately defending the RDE, has recently presented a reformulated and more detailed version of the rule. Thanks to its greater precision, this reinvented RDE avoids several problems thought to plague the traditional RDE. Although an improvement compared with the traditional version, we argue that Sulmasy's reinvented RDE will not stand closer scrutiny. Not only has the range of proper applicability narrowed significantly, but, more importantly, Sulmasy fails to establish that there is a morally relevant distinction between intended and foreseen effects. In particular, he fails to establish that there is any distinction that can account for the alleged moral difference between sedation therapy and euthanasia. © 2012 John Wiley & Sons Ltd.

Combined use of aortic dissection detection risk score and D-dimer in the diagnostic workup of suspected acute aortic dissection.

PubMed

Nazerian, Peiman; Morello, Fulvio; Vanni, Simone; Bono, Alessia; Castelli, Matteo; Forno, Daniela; Gigli, Chiara; Soardo, Flavia; Carbone, Federica; Lupia, Enrico; Grifoni, Stefano

2014-07-15

Acute aortic dissection (AD) represents a diagnostic conundrum. Validated algorithms are particularly needed to identify patients where AD could be ruled out without aortic imaging. We evaluated the diagnostic accuracy of a strategy combining the aortic dissection detection (ADD) risk score with D-dimer, a sensitive biomarker of AD. Patients from two clinical centers with suspected AD were prospectively enrolled in a registry, from January 2008 to March 2013. The ADD risk score was calculated by retrospective blinded chart review. For D-dimer, a cutoff of 500 ng/ml was applied. AD was diagnosed in 233 of 1035 (22.5%) patients. The ADD risk score was 0 in 322 (31.1%), 1 in 508 (49.1%) and >1 in 205 (19.8%) patients. The sensitivity and the failure rate of D-dimer were 100% and 0% in patients with ADD score 0, versus 97.5% (95% CI 91.4-99.6%) and 4.2% (95% CI 0.7-12.5%) in patients with ADD risk score >1. In patients with ADD risk score ≤ 1, the sensitivity and the failure rate of D-dimer were 98.7% (95% CI 95.3-99.8%) and 0.8% (95% CI 0.1-2.6%). The diagnostic efficiency of D-dimer in patients with ADD risk score 0 and ≤ 1 was 8.9% (95% CI 7.2-10.7%) and 23.6% (95% CI 21.1-26.2%) respectively. In a large cohort of patients with suspected AD, the presence of ADD risk score 0 or ≤ 1 combined with a negative D-dimer accurately and efficiently ruled out AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

47 CFR 90.1425 - Resolution of disputes after grant of the upper 700 MHz D block license.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to the NSA has deviated from the terms of the NSA, or a petition for a declaratory ruling to resolve the proper interpretation of an NSA term or provision. The Commission also may at any time, on its own motion, determine to address any material breach or interpret any NSA term or provision. (b) The...

47 CFR 27.1325 - Resolution of disputes after grant of the upper 700 MHz D block license.

Code of Federal Regulations, 2011 CFR

2011-10-01

... to the NSA has deviated from the terms of the NSA, or a petition for a declaratory ruling to resolve the proper interpretation of an NSA term or provision. The Commission also may at any time, on its own motion, determine to address any material breach or interpret any NSA term or provision. (b) The...

47 CFR 27.1325 - Resolution of disputes after grant of the upper 700 MHz D block license.

Code of Federal Regulations, 2012 CFR

2012-10-01

... to the NSA has deviated from the terms of the NSA, or a petition for a declaratory ruling to resolve the proper interpretation of an NSA term or provision. The Commission also may at any time, on its own motion, determine to address any material breach or interpret any NSA term or provision. (b) The...

47 CFR 90.1425 - Resolution of disputes after grant of the upper 700 MHz D block license.

Code of Federal Regulations, 2012 CFR

2012-10-01

... to the NSA has deviated from the terms of the NSA, or a petition for a declaratory ruling to resolve the proper interpretation of an NSA term or provision. The Commission also may at any time, on its own motion, determine to address any material breach or interpret any NSA term or provision. (b) The...

76 FR 13439 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... Change To Amend the Dividends Service Guide as It Relates to the Domestic Tax Reporting Service and the U... concerning the purpose of and basis for the proposed rule change and discussed any comments it received on... occurs, DTC participants need to be aware of it so they can properly prepare the IRS Forms 1099 they are...

International Trade: Rules of Origin

DTIC Science & Technology

2008-06-10

Well-known retailers (such as Walmart, Sears, and the Gap) and brand -name distributors of consumer products (such as Mattel, Nike , and Dell) utilize...Origin: Implications of Globalized Manufacturing Summary Determining the country of origin of a product is important for properly assessing tariffs...component parts originate in many countries, as is often the case in today’s global trading environment, determining origin can be a very complex

[Some ethical considerations, especially identity, during xenotransplantation].

PubMed

Cüer, P

2000-05-01

Provided that a pandemic due to retroviruses or prions eventually transmitted by animals is under control, in accordance with the fundamental ethical rule to serve the best interest of the patient, any organ xenotransplantation raises an important ethical dilemma: how to deliver proper and adapted information to the patient on the preservation of his identity. Xenotransplantation of any part of the brain seems to us unethical.

Planning and scheduling for success

NASA Technical Reports Server (NTRS)

Manzanera, Ignacio

1994-01-01

Planning and scheduling programs are excellent management tools when properly introduced to the project management team and regularly maintained. Communications, creativity, flexibility and accuracy are substantially improved by following a simple set of rules. A planning and scheduling program will work for you if you believe in it, make others in your project team realize its benefits, and make it an extension of your project cost control philosophy.

Biological activity of antitumoural MGBG: the structural variable.

PubMed

Marques, M P M; Gil, F P S C; Calheiros, R; Battaglia, V; Brunati, A M; Agostinelli, E; Toninello, A

2008-05-01

The present study aims at determining the structure-activity relationships (SAR's) ruling the biological function of MGBG (methylglyoxal bis(guanylhydrazone)), a competitive inhibitor of S-adenosyl-L-methionine decarboxylase displaying anticancer activity, involved in the biosynthesis of the naturally occurring polyamines spermidine and spermine. In order to properly understand its biochemical activity, MGBG's structural preferences at physiological conditions were ascertained, by quantum mechanical (DFT) calculations.

Pensions, investments, and taxation.

PubMed

Gerstein, Mitchell

2010-01-01

Having for retirement has become increasingly challenging with retirement plan rules changing along with taxes and investment choices. The only certainty is that everyone needs to save money in order to be able to stop working. The best plan for a small business can be complex and confusing but rewarding if designed properly. There are a number of options available and many factors to consider in choosing the most appropriate plan.

Energy-efficient neuron, synapse and STDP integrated circuits.

PubMed

Cruz-Albrecht, Jose M; Yung, Michael W; Srinivasa, Narayan

2012-06-01

Ultra-low energy biologically-inspired neuron and synapse integrated circuits are presented. The synapse includes a spike timing dependent plasticity (STDP) learning rule circuit. These circuits have been designed, fabricated and tested using a 90 nm CMOS process. Experimental measurements demonstrate proper operation. The neuron and the synapse with STDP circuits have an energy consumption of around 0.4 pJ per spike and synaptic operation respectively.

Switching between Spatial Stimulus-Response Mappings: A Developmental Study of Cognitive Flexibility

ERIC Educational Resources Information Center

Crone, Eveline A.; Ridderinkhof, K. Richard; Worm, Mijkje; Somsen, Riek J. M.; van der Molen, Maurits W.

2004-01-01

Four different age groups (8-9-year-olds, 11-12-year-olds, 13-15-year-olds and young adults) performed a spatial rule-switch task in which the sorting rule had to be detected on the basis of feedback or on the basis of switch cues. Performance errors were examined on the basis of a recently introduced method of error scoring for the Wisconsin Card…

Diagnosing Cognitive Errors: Statistical Pattern Classification and Recognition Approach

DTIC Science & Technology

1985-01-01

often produces several different erroneous rules. For example, when adding two fractions with different denominators, many students add the numerators ...common denominator and add the numerators . As listed in Tatsuoka (1984a), there are eleven different erroneous rules which result from a misconception...the score of five. These patterns correspond to different values of 42 (Tatsuoka, 1985) The numerator of 42 is divided into two parts in Equation (5

Veterinary Forensic Toxicology.

PubMed

Gwaltney-Brant, S M

2016-09-01

Veterinary pathologists working in diagnostic laboratories are sometimes presented with cases involving animal poisonings that become the object of criminal or civil litigation. Forensic veterinary toxicology cases can include cases involving animal cruelty (malicious poisoning), regulatory issues (eg, contamination of the food supply), insurance litigation, or poisoning of wildlife. An understanding of the appropriate approach to these types of cases, including proper sample collection, handling, and transport, is essential so that chain of custody rules are followed and proper samples are obtained for toxicological analysis. Consultation with veterinary toxicologists at the diagnostic laboratory that will be processing the samples before, during, and after the forensic necropsy can help to ensure that the analytical tests performed are appropriate for the circumstances and findings surrounding the individual case. © The Author(s) 2016.

Targeted Degradation of CTCF Decouples Local Insulation of Chromosome Domains from Genomic Compartmentalization.

PubMed

Nora, Elphège P; Goloborodko, Anton; Valton, Anne-Laure; Gibcus, Johan H; Uebersohn, Alec; Abdennur, Nezar; Dekker, Job; Mirny, Leonid A; Bruneau, Benoit G

2017-05-18

The molecular mechanisms underlying folding of mammalian chromosomes remain poorly understood. The transcription factor CTCF is a candidate regulator of chromosomal structure. Using the auxin-inducible degron system in mouse embryonic stem cells, we show that CTCF is absolutely and dose-dependently required for looping between CTCF target sites and insulation of topologically associating domains (TADs). Restoring CTCF reinstates proper architecture on altered chromosomes, indicating a powerful instructive function for CTCF in chromatin folding. CTCF remains essential for TAD organization in non-dividing cells. Surprisingly, active and inactive genome compartments remain properly segregated upon CTCF depletion, revealing that compartmentalization of mammalian chromosomes emerges independently of proper insulation of TADs. Furthermore, our data support that CTCF mediates transcriptional insulator function through enhancer blocking but not as a direct barrier to heterochromatin spreading. Beyond defining the functions of CTCF in chromosome folding, these results provide new fundamental insights into the rules governing mammalian genome organization. Copyright © 2017 Elsevier Inc. All rights reserved.

Targeted degradation of CTCF decouples local insulation of chromosome domains from genomic compartmentalization

PubMed Central

Nora, Elphège P.; Goloborodko, Anton; Valton, Anne-Laure; Gibcus, Johan H.; Uebersohn, Alec; Abdennur, Nezar; Dekker, Job; Mirny, Leonid A.; Bruneau, Benoit G.

2017-01-01

Summary The molecular mechanisms underlying folding of mammalian chromosomes remain poorly understood. The transcription factor CTCF is a candidate regulator of chromosomal structure. Using the auxin-inducible degron system in mouse embryonic stem cells, we show that CTCF is absolutely and dose-dependently required for looping between CTCF target sites and insulation of topologically associating domains (TADs). Restoring CTCF reinstates proper architecture on altered chromosomes, indicating a powerful instructive function for CTCF in chromatin folding. CTCF remains essential for TAD organization in non-dividing cells. Surprisingly, active and inactive genome compartments remain properly segregated upon CTCF depletion, revealing that compartmentalization of mammalian chromosomes emerges independently of proper insulation of TADs. Further, our data support that CTCF mediates transcriptional insulator function through enhancer-blocking but not as a direct barrier to heterochromatin spreading. Beyond defining the functions of CTCF in chromosome folding these results provide new fundamental insights into the rules governing mammalian genome organization. PMID:28525758

The arginylation branch of the N-end rule pathway positively regulates cellular autophagic flux and clearance of proteotoxic proteins

PubMed Central

Jiang, Yanxialei; Lee, Jeeyoung; Lee, Jung Hoon; Lee, Joon Won; Kim, Ji Hyeon; Choi, Won Hoon; Yoo, Young Dong; Cha-Molstad, Hyunjoo; Kim, Bo Yeon; Kwon, Yong Tae; Noh, Sue Ah; Kim, Kwang Pyo; Lee, Min Jae

2016-01-01

ABSTRACT The N-terminal amino acid of a protein is an essential determinant of ubiquitination and subsequent proteasomal degradation in the N-end rule pathway. Using para-chloroamphetamine (PCA), a specific inhibitor of the arginylation branch of the pathway (Arg/N-end rule pathway), we identified that blocking the Arg/N-end rule pathway significantly impaired the fusion of autophagosomes with lysosomes. Under ER stress, ATE1-encoded Arg-tRNA-protein transferases carry out the N-terminal arginylation of the ER heat shock protein HSPA5 that initially targets cargo proteins, along with SQSTM1, to the autophagosome. At the late stage of autophagy, however, proteasomal degradation of arginylated HSPA5 might function as a critical checkpoint for the proper progression of autophagic flux in the cells. Consistently, the inhibition of the Arg/N-end rule pathway with PCA significantly elevated levels of MAPT and huntingtin aggregates, accompanied by increased numbers of LC3 and SQSTM1 puncta. Cells treated with the Arg/N-end rule inhibitor became more sensitized to proteotoxic stress-induced cytotoxicity. SILAC-based quantitative proteomics also revealed that PCA significantly alters various biological pathways, including cellular responses to stress, nutrient, and DNA damage, which are also closely involved in modulation of autophagic responses. Thus, our results indicate that the Arg/N-end rule pathway may function to actively protect cells from detrimental effects of cellular stresses, including proteotoxic protein accumulation, by positively regulating autophagic flux. PMID:27560450

Self Adapted Testing as Formative Assessment: Effects of Feedback and Scoring on Engagement and Performance

ERIC Educational Resources Information Center

Arieli-Attali, Meirav

2016-01-01

This dissertation investigated the feasibility of self-adapted testing (SAT) as a formative assessment tool with the focus on learning. Under two different orientation goals--to excel on a test (performance goal) or to learn from the test (learning goal)--I examined the effect of different scoring rules provided as interactive feedback, on test…

Games as Formative Assessment Environments: Examining the Impact of Explanations of Scoring and Incentives on Math Learning, Game Performance, and Help Seeking

ERIC Educational Resources Information Center

Delacruz, Girlie Castro

2010-01-01

To investigate whether games may serve as useful formative assessment environments, this study examined, experimentally, the effects of two aspects of formative assessment on math achievement, game play, and help-seeking behaviors: (a) making assessment criteria explicit through the explanation of scoring rules and (b) incentivizing the use of…

States Eyeing Expense of Hand-Scored Tests in Light of NCLB Rules

ERIC Educational Resources Information Center

Archer, Jeff

2005-01-01

When students put down their pencils at the end of Connecticut's testing each year, another intensive process begins. Hundreds of trained evaluators work day and night for about a month to score the written responses. Although expensive, the use of open-ended questions drives the kind of instruction that state leaders say they want in their…

77 FR 34399 - Public Housing Assessment System (PHAS): Capital Fund Interim Scoring Notice; Request for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

...-indicator of the Capital Fund indicator to all PHAs for the Capital Fund Indicator under the PHAS interim... transition to the scoring system implemented by the PHAS interim rule, especially as relates to the indicator that assesses occupancy rate. The 5 points for the occupancy sub-indicator will be awarded for fiscal...

Application of a prediction model for the progression of rheumatoid arthritis in patients with undifferentiated arthritis.

PubMed

Arana-Guajardo, Ana; Pérez-Barbosa, Lorena; Vega-Morales, David; Riega-Torres, Janett; Esquivel-Valerio, Jorge; Garza-Elizondo, Mario

2014-01-01

Different prediction rules have been applied to patients with undifferentiated arthritis (UA) to identify those that progress to rheumatoid arthritis (RA). The Leiden Prediction Rule (LPR) has proven useful in different UA cohorts. To apply the LPR to a cohort of patients with UA of northeastern Mexico. We included 47 patients with UA, LPR was applied at baseline. They were evaluated and then classified after one year of follow-up into two groups: those who progressed to RA (according to ACR 1987) and those who did not. 43% of the AI patients developed RA. In the RA group, 56% of patients obtained a score ≤ 6 and only 15% ≥ 8. 70% who did not progress to RA had a score between 6 and ≤ 8. There was no difference in median score of LPR between groups, p=0.940. Most patients who progressed to RA scored less than 6 points in the LPR. Unlike what was observed in other cohorts, the model in our population did not allow us to predict the progression of the disease. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Validation of the Infectious Diseases Society of America/American Thoracic Society criteria to predict severe community-acquired pneumonia caused by Streptococcus pneumoniae.

PubMed

Kontou, Paschalina; Kuti, Joseph L; Nicolau, David P

2009-10-01

Severe community-acquired pneumonia (CAP) is usually defined as pneumonia that requires intensive care unit (ICU) admission; the primary pathogen responsible for ICU admission is Streptococcus pneumoniae. In this study, the 2007 Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) consensus criteria for ICU admission were compared with other severity scores in predicting ICU admission and mortality. We retrospectively studied 158 patients with pneumococcal CAP (1999-2003). Clinical and laboratory features at the emergency department were recorded and used to calculate the 2007 IDSA/ATS rule, the 2001 ATS rule, 2 modified 2007 IDSA/ATS rules, the Pneumonia Severity Index (PSI), and the CURB (confusion, urea, respiratory rate, blood pressure) score. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were assessed for the various indices. We also determined the criteria that were independently predictive of ICU admission and of mortality in our population. The 2007 IDSA/ATS criteria performed as well as the 2001 ATS rule in predicting ICU admission both demonstrated high sensitivity (90%) and NPV (97%). For the prediction of mortality, the best tool proved to be the PSI score (sensitivity, 95%; NPV, 99%). The variables associated with ICU admission in this patient population included tachypnea, confusion, Pao(2)/Fio(2) ratio of 250 or lower, and hypotension requiring fluid resuscitation. Mechanical ventilation and PSI class V were independently associated with mortality. This study confirms the usefulness of the new criteria in predicting severe CAP. The 2001 ATS criteria seem an attractive alternative because they are simple and as effective as the 2007 IDSA/ATS criteria.

Geriatric Fever Score: A New Decision Rule for Geriatric Care

PubMed Central

Vong, Si-Chon; Yang, Tzu-Meng; Chen, Kuo-Tai; Lin, Hung-Jung; Chen, Jiann-Hwa; Su, Shih-Bin; Guo, How-Ran; Hsu, Chien-Chin

2014-01-01

Background Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups. Materials and Methods Consecutive geriatric patients (≥65 years old) visiting the emergency department (ED) of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done. Results Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3), Severe coma (GCS ≤ 8), and Thrombocytopenia (platelets <150 103/mm3) (LST). After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0%) (95% CI: 2.3–6.9%): a general ward or treatment in the ED then discharge and high (30.3%) (95% CI: 17.4–47.3%): consider the intensive care unit. The area under the curve for the rule was 0.73. Conclusions We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need. PMID:25340811

Information as a Measure of Model Skill

NASA Astrophysics Data System (ADS)

Roulston, M. S.; Smith, L. A.

2002-12-01

Physicist Paul Davies has suggested that rather than the quest for laws that approximate ever more closely to "truth", science should be regarded as the quest for compressibility. The goodness of a model can be judged by the degree to which it allows us to compress data describing the real world. The "logarithmic scoring rule" is a method for evaluating probabilistic predictions of reality that turns this philosophical position into a practical means of model evaluation. This scoring rule measures the information deficit or "ignorance" of someone in possession of the prediction. A more applied viewpoint is that the goodness of a model is determined by its value to a user who must make decisions based upon its predictions. Any form of decision making under uncertainty can be reduced to a gambling scenario. Kelly showed that the value of a probabilistic prediction to a gambler pursuing the maximum return on their bets depends on their "ignorance", as determined from the logarithmic scoring rule, thus demonstrating a one-to-one correspondence between data compression and gambling returns. Thus information theory provides a way to think about model evaluation, that is both philosophically satisfying and practically oriented. P.C.W. Davies, in "Complexity, Entropy and the Physics of Information", Proceedings of the Santa Fe Institute, Addison-Wesley 1990 J. Kelly, Bell Sys. Tech. Journal, 35, 916-926, 1956.

Following the (Clinical Decision) Rules: Opportunities for Improving Safety and Resource Utilization With the Bacterial Meningitis Score.

PubMed

Hagedorn, Philip A; Shah, Samir S; Kirkendall, Eric S

2016-05-01

The Bacterial Meningitis Score accurately classifies children with cerebrospinal fluid (CSF) pleocytosis at very low risk (VLR) versus not very low risk (non-VLR) for bacterial meningitis. Most children with CSF pleocytosis detected during emergency department evaluation are hospitalized despite the high accuracy of this prediction rule and the decreasing incidence of bacterial meningitis. The lack of widespread use of this rule may contribute to unnecessary risk exposure and costs. This cross-sectional study included 1049 patients who, between January 2010 and May 2013, had suspicion for meningitis and underwent both a complete blood cell count and CSF studies during their emergency department evaluation. We then examined their hospitalizations to characterize exposure to drugs, radiologic studies, and the costs associated with their care to determine the safety and value repercussions of these VLR admissions. Primary outcomes include duration of antibiotics, exposure to drugs and radiology studies, safety events, and costs incurred during these VLR admissions. Twenty patients classified as VLR were admitted to the hospital. On average they received 35 hours of antibiotic therapy. There was 1 adverse drug event and 1 safety event. The VLR patients admitted to the hospital were exposed to risk and costs despite their low risk stratification. Systematic application of the Bacterial Meningitis Score could prevent these exposures and costs. Copyright © 2016 by the American Academy of Pediatrics

[The diagnostic scores for deep venous thrombosis].

PubMed

Junod, A

2015-08-26

Seven diagnostic scores for the deep venous thrombosis (DVT) of lower limbs are analyzed and compared. Two features make this exer- cise difficult: the problem of distal DVT and of their proximal extension and the status of patients, whether out- or in-patients. The most popular score is the Wells score (1997), modi- fied in 2003. It includes one subjective ele- ment based on clinical judgment. The Primary Care score 12005), less known, has similar pro- perties, but uses only objective data. The pre- sent trend is to associate clinical scores with the dosage of D-Dimers to rule out with a good sensitivity the probability of TVP. For the upper limb DVT, the Constans score (2008) is available, which can also be coupled with D-Dimers testing (Kleinjan).

Reconstruction of spatio-temporal temperature from sparse historical records using robust probabilistic principal component regression

USGS Publications Warehouse

Tipton, John; Hooten, Mevin B.; Goring, Simon

2017-01-01

Scientific records of temperature and precipitation have been kept for several hundred years, but for many areas, only a shorter record exists. To understand climate change, there is a need for rigorous statistical reconstructions of the paleoclimate using proxy data. Paleoclimate proxy data are often sparse, noisy, indirect measurements of the climate process of interest, making each proxy uniquely challenging to model statistically. We reconstruct spatially explicit temperature surfaces from sparse and noisy measurements recorded at historical United States military forts and other observer stations from 1820 to 1894. One common method for reconstructing the paleoclimate from proxy data is principal component regression (PCR). With PCR, one learns a statistical relationship between the paleoclimate proxy data and a set of climate observations that are used as patterns for potential reconstruction scenarios. We explore PCR in a Bayesian hierarchical framework, extending classical PCR in a variety of ways. First, we model the latent principal components probabilistically, accounting for measurement error in the observational data. Next, we extend our method to better accommodate outliers that occur in the proxy data. Finally, we explore alternatives to the truncation of lower-order principal components using different regularization techniques. One fundamental challenge in paleoclimate reconstruction efforts is the lack of out-of-sample data for predictive validation. Cross-validation is of potential value, but is computationally expensive and potentially sensitive to outliers in sparse data scenarios. To overcome the limitations that a lack of out-of-sample records presents, we test our methods using a simulation study, applying proper scoring rules including a computationally efficient approximation to leave-one-out cross-validation using the log score to validate model performance. The result of our analysis is a spatially explicit reconstruction of spatio-temporal temperature from a very sparse historical record.

Information management in Iranian Maternal Mortality Surveillance System.

PubMed

Sadoughi, Farahnaz; Karimi, Afsaneh; Erfannia, Leila

2017-07-01

Maternal mortality is preventable by proper information management and is the main target of the Maternal Mortality Surveillance System (MMSS). This study aimed to determine the status of information management in the Iranian Maternal Mortality Surveillance System (IMMSS). The population of this descriptive and analytical study, which was conducted in 2016, included 96 administrative staff of health and treatment deputies of universities of medical sciences and the Ministry of Health in Iran. Data were gathered by a five-part questionnaire with confirmed validity and reliability. A total of 76 questionnaires were completed, and data were analyzed using SPSS software, version 19, by descriptive and inferential statistics. The relationship between variables "organizational unit" and the four studied axes was studied using Kendall's correlation coefficient test. The status of information management in IMMSS was desirable. Data gathering and storage axis and data processing and compilation axis achieved the highest (2.7±0.46) and the lowest (2.4±0.49) mean scores, respectively. The data-gathering method, control of a sample of women deaths in reproductive age in the universities of medical sciences, use of international classification of disease, and use of this system information by management teams to set resources allocation achieved the lowest mean scores in studied axes. Treatment deputy staff had a more positive attitude toward the status of information management of IMMSS than the health deputy staff (p=0.004). Although the status of information management in IMMSS was desirable, it could be improved by modification of the data-gathering method; creating communication links between different data resources; a periodic sample control of women deaths in reproductive age in the universities of medical sciences; and implementing ICD-MM and integration of its rules on a unified system of death.

Proposed Clinical Decision Rules to Diagnose Acute Rhinosinusitis Among Adults in Primary Care.

PubMed

Ebell, Mark H; Hansen, Jens Georg

2017-07-01

To reduce inappropriate antibiotic prescribing, we sought to develop a clinical decision rule for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. Multivariate analysis and classification and regression tree (CART) analysis were used to develop clinical decision rules for the diagnosis of acute rhinosinusitis, defined using 3 different reference standards (purulent antral puncture fluid or abnormal finding on a computed tomographic (CT) scan; for acute bacterial rhinosinusitis, we used a positive bacterial culture of antral fluid). Signs, symptoms, C-reactive protein (CRP), and reference standard tests were prospectively recorded in 175 Danish patients aged 18 to 65 years seeking care for suspected acute rhinosinusitis. For each reference standard, we developed 2 clinical decision rules: a point score based on a logistic regression model and an algorithm based on a CART model. We identified low-, moderate-, and high-risk groups for acute rhinosinusitis or acute bacterial rhinosinusitis for each clinical decision rule. The point scores each had between 5 and 6 predictors, and an area under the receiver operating characteristic curve (AUROCC) between 0.721 and 0.767. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a 16%, 49%, and 73% likelihood of acute bacterial rhinosinusitis, respectively. CART models had an AUROCC ranging from 0.783 to 0.827. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a likelihood of acute bacterial rhinosinusitis of 6%, 31%, and 59% respectively. We have developed a series of clinical decision rules integrating signs, symptoms, and CRP to diagnose acute rhinosinusitis and acute bacterial rhinosinusitis with good accuracy. They now require prospective validation and an assessment of their effect on clinical and process outcomes. © 2017 Annals of Family Medicine, Inc.

Assessing the uniqueness of language: Animal grammatical abilities take center stage.

PubMed

Ten Cate, Carel

2017-02-01

Questions related to the uniqueness of language can only be addressed properly by referring to sound knowledge of the relevant cognitive abilities of nonhuman animals. A key question concerns the nature and extent of animal rule-learning abilities. I discuss two approaches used to assess these abilities. One is comparing the structures of animal vocalizations to linguistic ones, and another is addressing the grammatical rule- and pattern-learning abilities of animals through experiments using artificial grammars. Neither of these approaches has so far provided unambiguous evidence of advanced animal abilities. However, when we consider how animal vocalizations are analyzed, the types of stimuli and tasks that are used in artificial grammar learning experiments, the limited number of species examined, and the groups to which these belong, I argue that the currently available evidence is insufficient to arrive at firm conclusions concerning the limitations of animal grammatical abilities. As a consequence, the gap between human linguistic rule-learning abilities and those of nonhuman animals may be smaller and less clear than is currently assumed. This means that it is still an open question whether a difference in the rule-learning and rule abstraction abilities between animals and humans played the key role in the evolution of language.

The Link Between Nutrition and Physical Activity in Increasing Academic Achievement.

PubMed

Asigbee, Fiona M; Whitney, Stephen D; Peterson, Catherine E

2018-06-01

Research demonstrates a link between decreased cognitive function in overweight school-aged children and improved cognitive function among students with high fitness levels and children engaging in regular physical activity (PA). The purpose of this study was to examine whether regular PA and proper nutrition together had a significant effect on academic achievement. Using the seventh wave of the Early Childhood Longitudinal Study, Kindergarten Class 1998-99 (ECLS-K) dataset, linear regression analysis with a Jackknife resampling correction was conducted to analyze the relationship among nutrition, PA, and academic achievement, while controlling for socioeconomic status, age, and sex. A nonactive, unhealthy nutrition group and a physically active, healthy nutrition group were compared on standardized tests of academic achievement. Findings indicated that PA levels and proper nutrition significantly predicted achievement scores. Thus, the active, healthy nutrition group scored higher on reading, math, and science standardized achievement tests scores. There is a strong connection between healthy nutrition and adequate PA, and the average performance within the population. Thus, results from this study suggest a supporting relationship between students' health and academic achievement. Findings also provide implications for school and district policy changes. © 2018, American School Health Association.

Contextual interference effects on the acquisition of skill and strength of the bench press.

PubMed

Naimo, Marshall A; Zourdos, Michael C; Wilson, Jacob M; Kim, Jeong-Su; Ward, Emery G; Eccles, David W; Panton, Lynn B

2013-06-01

The purpose of this study was to investigate contextual interference effects on skill acquisition and strength gains during the learning of the bench press movement. Twenty-four healthy, college-aged males and females were stratified to control, high contextual interference (HCI), and low contextual interference (LCI) groups. Treatment groups were provided with written and visual instruction on proper bench press form and practiced the bench press and dart throwing for four weeks. Within each session, LCI performed all bench press sets before undertaking dart-throws. HCI undertook dart-throws immediately following each set of bench press. Control only did testing. Measurements, including one repetition maximum (1RM), checklist scores based on video recordings of participants' 1RM's, and dart-throw test scores were taken at pre-test, 1 week, 2 week, post-test, and retention test. Results were consistent with the basic premise of the contextual interference effect. LCI had significant improvements in percent 1RM and checklist scores during training, but were mostly absent after training (post-test and retention test). HCI had significant improvements in percent 1RM and checklist scores both during and after training. Thus, HCI may augment strength and movement skill on the bench press since proper technique is an important component of resistance exercise movements. Copyright © 2013 Elsevier B.V. All rights reserved.

Assessment of the 2016 National Institute for Health and Care Excellence high-sensitivity troponin rule-out strategy

PubMed Central

Greenslade, Jaimi; Cullen, Louise; Than, Martin; Kendall, Jason; Body, Richard; Parsonage, William A; Khattab, Ahmed

2018-01-01

Objective We aimed to evaluate the limit of detection of high-sensitivity troponin (hs-cTn) and Thrombolysis In Myocardial Infarction (TIMI) score combination rule-out strategy suggested within the 2016 National Institute for Health and Care Excellence (NICE) Chest Pain of Recent Onset guidelines and establish the optimal TIMI score threshold for clinical use. Methods A pooled analysis of adult patients presenting to the emergency department with chest pain and a non-ischaemic ECG, recruited into six prospective studies, from Australia, New Zealand and the UK. We evaluated the sensitivity of TIMI score thresholds from 0 to 2 alongside hs-cTnT or hs-cTnI for the primary outcome of major adverse cardiac events within 30 days. Results Data were available for 3159 patients for hs-cTnT and 4532 for hs-cTnI, of these 376 (11.9%) and 445 (9.8%) had major adverse cardiac events, respectively. Using a TIMI score of 0, the sensitivity for the primary outcome was 99.5% (95% CI 98.1% to 99.9%) alongside hs-cTnT and 98.9% (97.4% to 99.6%)%) alongside hs-cTnI, identifying 17.9% and 21.0% of patients as low risk, respectively. For a TIMI score ≤1 sensitivity was 98.9% (97.3% to 99.7%)%) alongside hs-cTnT and 98.4% (96.8% to 99.4%)%) alongside hs-cTnI, identifying 28.1% and 35.7% as low risk, respectively. For TIMI≤2, meta-sensitivity was <98% with either assay. Conclusions Our findings support the rule-out strategy suggested by NICE. The TIMI score threshold suggested for clinical use is 0. The proportion of patients identified as low risk (18%–21%) and suitable for early discharge using this threshold may be sufficient to encourage change of practice. Trial registration numbers ADAPT observational study/IMPACT intervention trial ACTRN12611001069943. ADAPT-ADP randomised controlled trial ACTRN12610000766011. EDACS-ADP randomised controlled trial ACTRN12613000745741. TRUST observational study ISRCTN no. 21109279. PMID:28864718

26 CFR 20.2204-3 - Special rules for estates of decedents dying after December 31, 1976; special lien under section...

Code of Federal Regulations, 2010 CFR

2010-04-01

...) and 20.2204-2(b), in the case of a decedent dying after December 31, 1976, if the executor elects a..., the executor may not thereafter substitute a bond pursuant to section 2204 in lieu of that lien. If a bond has been supplied under section 2204, however,the executor may, by filing a proper notice of...

More about natural family planning.

PubMed

Gallagher, J

1983-11-01

When properly taught and practised, natural family planning can be a highly effective form of birth regulation. Recent studies indicate low failure rates of less than three pregnancies per 100 women years for couples with a strong motivation to follow the method. Studies show that pregnancy rates are high when the rules for avoiding pregnancy are not adhered to. Successful natural family planning can lead to heightened self esteem and marital enrichment.

26 CFR 1.663(a)-1 - Special rules applicable to sections 661 and 662; exclusions; gifts, bequests, etc.

Code of Federal Regulations, 2010 CFR

2010-04-01

...; exclusions; gifts, bequests, etc. (a) In general. A gift or bequest of a specific sum of money or of specific property, which is required by the specific terms of the will or trust instrument and is properly paid or... trust instrument the gift or bequest is to be paid or credited to the recipient in more than three...

The use of debt.

PubMed

Hood, W L; Loughery, C V

1990-05-01

Stewards of Catholic healthcare organizations must proceed cautiously before embarking on new construction or renovation projects. Many important issues are involved in financing such projects, including business risk, financial philosophy, financial structure, and forms of debt. The proper foundation for any financing structure must begin with financial philosophy. Some healthcare facilities have traditionally used no external financing; others have employed significant levels of debt. To determine a proper level of debt for the project(s) being financed, it is important to look at business risk. If a modest decline in revenues (or a similar increase in costs) would threaten the project's viability, the business risk would be high; therefore prudence would dictate that the level of debt undertaken be relatively small. A separate analysis is required to determine the appropriate mix of floating-rate and fixed-rate long-term debt. As a rule of thumb, fixed-rate debt would typically form two thirds of the debt structure; floating-rate debt, no more than one third. For healthcare, debt can take two forms: tax exempt and taxable. Tax-exempt financing has many constraints, including use of proceeds by a tax-exempt entity, arbitrage rules, tax legislation, and financial disclosure laws. Taxable debt can be issued by private placement or on a publicly traded basis.

Revisiting the rotating call schedule in less than 80 hours per week.

PubMed

Roses, Robert E; Foley, Paul J; Paulson, Emily C; Pray, Lori; Kelz, Rachel R; Williams, Noel N; Morris, Jon B

2009-01-01

The Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions have prompted many surgical training programs to adopt a night-float resident coverage system (NF). Dissatisfaction with NF prompted us to transition to a rotating junior resident call model (Q4) with 24-hour call shifts at the outset of the 2007-2008 academic year. We performed a prospective study to determine the influence of this transition on resident education, morale, and quality of life, as well as on ACGME work rule compliance and American Board of Surgery In-Training Examination (ABSITE) scores. Residents were surveyed after 1 year of NF and again 1 year after the introduction of Q4. Responses to a series of statements about the influence of the call model (NF or Q4) on educational opportunities and morale were solicited. The survey used a 5-point Likert response scale (1 = complete disagreement to 5 = complete agreement). Median values of participant responses were calculated and compared using the Wilcoxon rank-sum test. Compliance with ACGME work rules, ABSITE scores, and operative case logs from the 2006-2007 and 2007-2008 academic years were also compared. Residents were significantly more enthusiastic about Q4 compared with NF, particularly when asked about the influence these systems had on morale (median response = 4.0 [Q4] compared with 2.0 [NF]; p = 0.001) and engagement of residents by the teaching faculty (median response = 4.0 [Q4] compared with 1.0 [NF]; p = 0.001). Case logs revealed a similar operative experience for first-year residents irrespective of the call schedule (p = 0.51). Excellent compliance with ACGME work rules was maintained as reflected by the percentage of monthly 80-hour violations per resident months worked (3% [Q4] compared with 0.7% [NF]). No difference was observed in the ABSITE scores of first-year residents (a mean percentile point increase of 1 was found after the introduction of Q4). Educational opportunities, compliance with ACGME work rules, and ABSITE scores can be preserved despite a transition from NF to Q4. Residents greatly prefer a rotating call schedule.

A rule-based automatic sleep staging method.

PubMed

Liang, Sheng-Fu; Kuo, Chin-En; Hu, Yu-Han; Cheng, Yu-Shian

2012-03-30

In this paper, a rule-based automatic sleep staging method was proposed. Twelve features including temporal and spectrum analyses of the EEG, EOG, and EMG signals were utilized. Normalization was applied to each feature to eliminating individual differences. A hierarchical decision tree with fourteen rules was constructed for sleep stage classification. Finally, a smoothing process considering the temporal contextual information was applied for the continuity. The overall agreement and kappa coefficient of the proposed method applied to the all night polysomnography (PSG) of seventeen healthy subjects compared with the manual scorings by R&K rules can reach 86.68% and 0.79, respectively. This method can integrate with portable PSG system for sleep evaluation at-home in the near future. Copyright © 2012 Elsevier B.V. All rights reserved.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2017, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and SNF Payment Models Research. Final rule.

PubMed

2016-08-05

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2017. In addition, it specifies a potentially preventable readmission measure for the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), and implements requirements for that program, including performance standards, a scoring methodology, and a review and correction process for performance information to be made public, aimed at implementing value-based purchasing for SNFs. Additionally, this final rule includes additional polices and measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). This final rule also responds to comments on the SNF Payment Models Research (PMR) project.

Optimizing glenosphere position and fixation in reverse shoulder arthroplasty, Part One: The twelve-mm rule.

PubMed

Kelly, James D; Humphrey, C Scott; Norris, Tom R

2008-01-01

The Aequalis Reversed Shoulder Prosthesis (Tornier, Inc., Edina, MN) is a successful treatment option for older, low-demand patients with rotator cuff arthropathy. Scapular notching is the most common radiographic complication and is associated with poorer intermediate-term clinical outcomes. Aligning the lower border of the glenosphere baseplate with the inferior glenoid rim has been recommended to reduce this complication, but guidelines for achieving this positioning are currently lacking. The purpose of this study is to develop a rule of thumb that will facilitate proper glenosphere component positioning intraoperatively. Utilizing a computed tomography-templating protocol, we found that the ideal location of the drill hole for the baseplate post was 11.5 +/- 1.0 mm above the inferior glenoid rim. On the basis of measurements from 10 implanted cadaveric specimens, we concluded that drilling the baseplate posthole 12 mm above the inferior glenoid rim-the 12-mm rule-will result in excellent glenosphere position in most cases.

Analysis and optimization of Love wave liquid sensors.

PubMed

Jakoby, B; Vellekoop, M J

1998-01-01

Love wave sensors are highly sensitive microacoustic devices, which are well suited for liquid sensing applications thanks to the shear polarization of the wave. The sensing mechanism thereby relies on the mechanical (or acoustic) interaction of the device with the liquid. The successful utilization of Love wave devices for this purpose requires proper shielding to avoid unwanted electric interaction of the liquid with the wave and the transducers. In this work we describe the effects of this electric interaction and the proper design of a shield to prevent it. We present analysis methods, which illustrate the impact of the interaction and which help to obtain an optimized design of the proposed shield. We also present experimental results for devices that have been fabricated according to these design rules.

Coreference analysis in clinical notes: a multi-pass sieve with alternate anaphora resolution modules.

PubMed

Jonnalagadda, Siddhartha Reddy; Li, Dingcheng; Sohn, Sunghwan; Wu, Stephen Tze-Inn; Wagholikar, Kavishwar; Torii, Manabu; Liu, Hongfang

2012-01-01

This paper describes the coreference resolution system submitted by Mayo Clinic for the 2011 i2b2/VA/Cincinnati shared task Track 1C. The goal of the task was to construct a system that links the markables corresponding to the same entity. The task organizers provided progress notes and discharge summaries that were annotated with the markables of treatment, problem, test, person, and pronoun. We used a multi-pass sieve algorithm that applies deterministic rules in the order of preciseness and simultaneously gathers information about the entities in the documents. Our system, MedCoref, also uses a state-of-the-art machine learning framework as an alternative to the final, rule-based pronoun resolution sieve. The best system that uses a multi-pass sieve has an overall score of 0.836 (average of B(3), MUC, Blanc, and CEAF F score) for the training set and 0.843 for the test set. A supervised machine learning system that typically uses a single function to find coreferents cannot accommodate irregularities encountered in data especially given the insufficient number of examples. On the other hand, a completely deterministic system could lead to a decrease in recall (sensitivity) when the rules are not exhaustive. The sieve-based framework allows one to combine reliable machine learning components with rules designed by experts. Using relatively simple rules, part-of-speech information, and semantic type properties, an effective coreference resolution system could be designed. The source code of the system described is available at https://sourceforge.net/projects/ohnlp/files/MedCoref.

Design Characteristics Influence Performance of Clinical Prediction Rules in Validation: A Meta-Epidemiological Study.

PubMed

Ban, Jong-Wook; Emparanza, José Ignacio; Urreta, Iratxe; Burls, Amanda

2016-01-01

Many new clinical prediction rules are derived and validated. But the design and reporting quality of clinical prediction research has been less than optimal. We aimed to assess whether design characteristics of validation studies were associated with the overestimation of clinical prediction rules' performance. We also aimed to evaluate whether validation studies clearly reported important methodological characteristics. Electronic databases were searched for systematic reviews of clinical prediction rule studies published between 2006 and 2010. Data were extracted from the eligible validation studies included in the systematic reviews. A meta-analytic meta-epidemiological approach was used to assess the influence of design characteristics on predictive performance. From each validation study, it was assessed whether 7 design and 7 reporting characteristics were properly described. A total of 287 validation studies of clinical prediction rule were collected from 15 systematic reviews (31 meta-analyses). Validation studies using case-control design produced a summary diagnostic odds ratio (DOR) 2.2 times (95% CI: 1.2-4.3) larger than validation studies using cohort design and unclear design. When differential verification was used, the summary DOR was overestimated by twofold (95% CI: 1.2 -3.1) compared to complete, partial and unclear verification. The summary RDOR of validation studies with inadequate sample size was 1.9 (95% CI: 1.2 -3.1) compared to studies with adequate sample size. Study site, reliability, and clinical prediction rule was adequately described in 10.1%, 9.4%, and 7.0% of validation studies respectively. Validation studies with design shortcomings may overestimate the performance of clinical prediction rules. The quality of reporting among studies validating clinical prediction rules needs to be improved.

Demographic factors and retrieval of object and proper names after age 70

PubMed Central

Fridkin, Shimon; Ayalon, Liat

2018-01-01

Purpose This research aimed to investigate whether demographic factors are similarly related to retrieval of object and proper names. Methods The sample included 5,907 individuals above age 70 who participated in the Health and Retirement Study between 2004 and 2012. Participants were asked to name two objects as well as the US President and Vice President. Latent growth curve models examined the associations of age, education, and self-rated health with baseline levels and change trajectories in retrieval. Results Age and education were more strongly related to retrieval of proper names than to retrieval of object names, both for baseline scores and for change trajectory. Similar effects of self-rated health emerged for both types of stimuli. Conclusions The results show that examining object names and proper names together as indication of cognitive status in the HRS might overlook important differences between the two types of stimuli, in both baseline performance and longitudinal change. PMID:29370264

7 CFR 52.809 - Character.

Code of Federal Regulations, 2010 CFR

2010-01-01

... score of 27 to 30 points. “Good character” means that the cherries are thick-fleshed and have a firm... limiting rule). “Reasonably good character” means that the cherries may be reasonably thick-fleshed and...

Integration of a knowledge-based system and a clinical documentation system via a data dictionary.

PubMed

Eich, H P; Ohmann, C; Keim, E; Lang, K

1997-01-01

This paper describes the design and realisation of a knowledge-based system and a clinical documentation system linked via a data dictionary. The software was developed as a shell with object oriented methods and C++ for IBM-compatible PC's and WINDOWS 3.1/95. The data dictionary covers terminology and document objects with relations to external classifications. It controls the terminology in the documentation program with form-based entry of clinical documents and in the knowledge-based system with scores and rules. The software was applied to the clinical field of acute abdominal pain by implementing a data dictionary with 580 terminology objects, 501 document objects, and 2136 links; a documentation module with 8 clinical documents and a knowledge-based system with 10 scores and 7 sets of rules.

Models for Scoring Missing Responses to Multiple-Choice Items. Program Statistics Research Technical Report No. 94-1.

ERIC Educational Resources Information Center

Longford, Nicholas T.

This study is a critical evaluation of the roles for coding and scoring of missing responses to multiple-choice items in educational tests. The focus is on tests in which the test-takers have little or no motivation; in such tests omitting and not reaching (as classified by the currently adopted operational rules) is quite frequent. Data from the…

Approval of information collection requirements for the joint interim rules for health insurance portability for group health plans, and the individual market health insurance reform: portability from group to individual coverage; federal rules for access in the individual market; state alternative mechanisms to federal rules--IRS, DOL, HCFA. Interim rules with request for comments; approval of information collection requirements.

PubMed

1997-07-02

On April 8, 1997, the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (Departments) published joint interim rules governing the access, portability and renewability requirements for group health plans and issuers offering group health insurance coverage in connection with a group health plan. The rules implemented changes made to certain provisions of the Internal Revenue Code of 1986 (Code), the Employee Retirement Income Security Act of 1974 (ERISA), and the Public Health Service Act (PHS Act) enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In the April 8 publication, the Departments submitted the group market information collection requirements, for, among other things, establishing creditable coverage, notice of special enrollment rights, and notice of pre-existing condition exclusion periods, to be Office of Management and Budget (OMB) for emergency review under the Paperwork Reduction Act of 1995 (PRA 95). In addition, on April 8, 1997 the Department of Health and Human Services submitted the HIPAA individual market information collection requirements to OMB for emergency review under the PRA 1995. This document amends the April 8 Federal Register documents to properly display the OMB control numbers.

Forward-Chaining Versus A Graph Approach As The Inference Engine In Expert Systems

NASA Astrophysics Data System (ADS)

Neapolitan, Richard E.

1986-03-01

Rule-based expert systems are those in which a certain number of IF-THEN rules are assumed to be true. Based on the verity of some assertions, the rules deduce as many new conclusions as possible. A standard technique used to make these deductions is forward-chaining. In forward-chaining, the program or 'inference engine' cycles through the rules. At each rule, the premises for the rule are checked against the current true assertions. If all the premises are found, the conclusion is added to the list of true assertions. At that point it is necessary to start over at the first rule, since the new conclusion may be a premise in a rule already checked. Therefore, each time a new conclusion is deduced it is necessary to start the rule checking procedure over. This process continues until no new conclusions are added and the end of the list of rules is reached. The above process, although quite costly in terms of CPU cycles due to the necessity of repeatedly starting the process over, is necessary if the rules contain 'pattern variables'. An example of such a rule is, 'IF X IS A BACTERIA, THEN X CAN BE TREATED WITH ANTIBIOTICS'. Since the rule can lead to conclusions for many values of X, it is necessary to check each premise in the rule against every true assertion producing an association list to be used in the checking of the next premise. However, if the rule does not contain variable data, as is the case in many current expert systems, then a rule can lead to only one conclusion. In this case, the rules can be stored in a graph, and the true assertions in an assertion list. The assertion list is traversed only once; at each assertion a premise is triggered in all the rules which have that assertion as a premise. When all premises for a rule trigger, the rule's conclusion is added to the END of the list of assertions. It must be added at the end so that it will eventually be used to make further deductions. In the current paper, the two methods are described in detail, the relative advantages of each is discussed, and a benchmark comparing the CPU cycles consumed by each is included. It is also shown that, in the case of reasoning under uncertainty, it is possible to properly combine the certainties derived from rules arguing for the same conclusion when the graph approach is used.

Protective Role of Parenting Attitude on the Behavioral and Neurocognitive Development of the Children from Economically Disadvantaged Families.

PubMed

Jung, Da-Eun; Bhang, Soo-Young; Lee, Won-Hye; Yoon, Hae-Joo; Jung, Hee-Yeon; Kim, Yeni

2018-06-01

Association between home environment and the behavioral and neurocognitive development of children from a community childcare center for low-income families was examined (aged 6 to 12 years, n=155). The parents performed a questionnaire on home environment (K-HOME-Q) to assess home environment including parenting attitude and the Child Behavior Checklist (K-CBCL). The children performed the Wechsler Intelligence (IQ) Scale, Stroop interference test (Stroop), word fluency test (WF), and design fluency test (DF) to assess their neurocognitive development. 'Nurturing of Development' and 'Variety of Language Interaction' scores from the K-HOME-Q, were inversely associated with total behavior problems, externalization, rule-breaking, and aggressive behavior subscales of K-CBCL, and 'Emotional atmosphere' and 'Tolerance toward the child' scores showed inverse associations with the total behavior problems, rule-breaking, aggressive behavior, and withdrawn/depressed subscales. Despite economic hardship, the mean scores of the neurocognitive tests were comparable to the average level of Korean children's normative sample. However, 'Nurturing of Development' and 'Tolerance toward the Child' score of K-HOME-Q were associated with better executive function (IQ, WF, DF). These results suggest that parental stimulation of development and tolerant parenting attitude may offer protection against the negative effects of suboptimal economic environment on children's behavior and neurocognitive development.

Evaluation of the level of depression among medical students from Poland, Portugal and Germany.

PubMed

Seweryn, Mariusz; Tyrała, Kinga; Kolarczyk-Haczyk, Aleksandra; Bonk, Magdalena; Bulska, Weronika; Krysta, Krzysztof

2015-09-01

Depression is a serious illness affecting health, family and professional life of many people of all sectors of society. It also concerns students, regardless of their geographical location. The Beck Depression Inventory (BDI) is a proper tool to brief check of the level of depression because it has high correlation with depression. The aim of this study was to assess and compare the level of depression among medical students from Poland, Portugal and Germany. Students from different countries were asked to fill in an electronic form containing the BDI. The form was created separately for each country, using official translation of the BDI, approved by the competent psychiatric association. Google Drive software was used for the electronic form, and Stat soft Statistica v10 software for statistical analysis. There were statistically significant differences (p<0.05) in terms of average score of the BDI and of the proportion of the scores more than 10 points of medical and technology students among kinds of studies and countries. The average score of the BDI of medical students: Poland: 13.76±9.99 points; Germany: 8.49±7.64 points; Portugal: 7.37±7.67 points. The average score of the BDI of technology students: Poland: 12.42±9.66 points; Germany: 10.51±8.49 points; Portugal: 9.25±8.97 points. The proportion of the scores more than 10 points of medical students: Poland 56.32% (285/506) Germany 34.92% (154/441) Portugal 26.03% (82/315). The proportion of the scores more than 10 points of technology students: Poland 55.01% (368/669) Germany 43.82% (156/356) Portugal 37.57% (136/362). The highest depression score among medical and technology students according the BDI was found in Poland. A proper monitoring of depression is required, as well as rapid and appropriate help for those who suffer from it.

Assessing self-care and social function using a computer adaptive testing version of the pediatric evaluation of disability inventory.

PubMed

Coster, Wendy J; Haley, Stephen M; Ni, Pengsheng; Dumas, Helene M; Fragala-Pinkham, Maria A

2008-04-01

To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the self-care and social function scales of the Pediatric Evaluation of Disability Inventory compared with the full-length version of these scales. Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study. Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children's homes. Children with disabilities (n=469) and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). Not applicable. Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length self-care and social function scales; time (in seconds) to complete assessments and respondent ratings of burden. Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (r range, .94-.99). Using computer simulation of retrospective data, discriminant validity, and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared with over 16 minutes to complete the full-length scales. Self-care and social function score estimates from CAT administration are highly comparable with those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time.

Changes in Legal Aspects of Public Education about Drugs and Their Importance.

PubMed

Miyamoto, Noriko

2016-01-01

Requirements for education on proper use of drugs were included in the junior high school educational guideline in 2012 incorporating pharmaceutical education in the obligatory school curriculum. This move is closely related to the country's new OTC drug marketing system. The amendment of the Pharmaceutical Affairs Law (PAL) in 2013 highlighted the public's own role in "promoting proper use of drugs and other related products and making greater efforts to acquire knowledge and improve understanding of their effective and safe use". Furthermore, the Law to Amend the PAL and Pharmacists Law enforced in 2014 allowed all OTC drugs to be sold online under appropriate rules. Deregulation of online sale of OTC drugs is expected further to promote self-medication for minor illnesses and require stricter measures to ensure people's safety through their proper use. These legal amendments in recent years have made people's education about proper use of drugs one of the top priorities Japan should pursue at state level. Since 2000, the author has been offering education on drugs to early primary school children as part of their healthcare education program. In the future, dedicated education on drugs will be necessary for people of all ages including not only school children but also their guardians and elderly citizens as well.

Under Voltage Lock-Out Design Rules for Proper Start-Up of Energy Autonomous Systems Powered by Supercapacitors

NASA Astrophysics Data System (ADS)

Boitier, V.; Durand Estèbe, P.; Monthéard, R.; Bafleur, M.; Dilhac, J. M.

2013-12-01

This paper deals with the issue of the initial start-up of an autonomous and battery-free system powered by an energy harvester associated with a storage subsystem based on supercapacitors initially discharged. A review of different low power Under Voltage Lock-Out (UVLO) solutions used to delay the load start-up and to avoid a useless discharge of supercapacitors is presented and discussed.

MOA-2011-BLG-262Lb: A sub-Earth-mass moon orbiting a gas giant primary or a high velocity planetary system in the galactic Bulge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bennett, D. P.; Batista, V.; Bond, I. A.

2014-04-20

We present the first microlensing candidate for a free-floating exoplanet-exomoon system, MOA-2011-BLG-262, with a primary lens mass of M {sub host} ∼ 4 Jupiter masses hosting a sub-Earth mass moon. The argument for an exomoon hinges on the system being relatively close to the Sun. The data constrain the product M{sub L} π{sub rel} where M{sub L} is the lens system mass and π{sub rel} is the lens-source relative parallax. If the lens system is nearby (large π{sub rel}), then M{sub L} is small (a few Jupiter masses) and the companion is a sub-Earth-mass exomoon. The best-fit solution has amore » large lens-source relative proper motion, μ{sub rel} = 19.6 ± 1.6 mas yr{sup –1}, which would rule out a distant lens system unless the source star has an unusually high proper motion. However, data from the OGLE collaboration nearly rule out a high source proper motion, so the exoplanet+exomoon model is the favored interpretation for the best fit model. However, there is an alternate solution that has a lower proper motion and fits the data almost as well. This solution is compatible with a distant (so stellar) host. A Bayesian analysis does not favor the exoplanet+exomoon interpretation, so Occam's razor favors a lens system in the bulge with host and companion masses of M{sub host}=0.12{sub −0.06}{sup +0.19} M{sub ⊙} and m{sub comp}=18{sub −10}{sup +28} M{sub ⊕}, at a projected separation of a{sub ⊥}=0.84{sub −0.14}{sup +0.25} AU. The existence of this degeneracy is an unlucky accident, so current microlensing experiments are in principle sensitive to exomoons. In some circumstances, it will be possible to definitively establish the mass of such lens systems through the microlensing parallax effect. Future experiments will be sensitive to less extreme exomoons.« less

7 CFR 52.781 - Character.

Code of Federal Regulations, 2010 CFR

2010-01-01

... score of 27 to 30 points. “Good character” means that the cherries are thick-fleshed and have a firm... limiting rule). “Reasonably good character” means that the cherries may be reasonably thick-fleshed and may...

Independent Orbiter Assessment (IOA): FMEA/CIL instructions and ground rules

NASA Technical Reports Server (NTRS)

Traves, S. T.

1986-01-01

The McDonnell Douglas Astronautics Company was selected to conduct an independent assessment of the Orbiter Failure Mode and Effects Analysis/Critical Items List (FMEA/CIL). Part of this effort involved an examination of the FMEA/CIL preparation instructions and ground rules. Assessment objectives were to identify omissions and ambiguities in the ground rules that may impede the identification of shuttle orbiter safety and mission critical items, and to ensure that ground rules allow these items to receive proper management visibility for risk assessment. Assessment objectives were followed during the performance of the assessment without being influenced by external considerations such as effects on budget, schedule, and documentation growth. Assessment personnel were employed who had a strong reliability background but no previous space shuttle FMEA/CIL experience to ensure an independent assessment would be achieved. The following observations were made: (1) not all essential items are in the CIL for management visibility; (2) ground rules omit FMEA/CIL coverage of items that perform critical functions; (3) essential items excluded from the CIL do not receive design justification; and (4) FMEAs/CILs are not updated in a timely manner. In addition to the above issues, a number of other issues were identified that correct FMEA/CIL preparation instruction omissions and clarify ambiguities. The assessment was successful in that many of the issues have significant safety implications.

Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard.

PubMed

Danker-Hopfe, Heidi; Anderer, Peter; Zeitlhofer, Josef; Boeck, Marion; Dorn, Hans; Gruber, Georg; Heller, Esther; Loretz, Erna; Moser, Doris; Parapatics, Silvia; Saletu, Bernd; Schmidt, Andrea; Dorffner, Georg

2009-03-01

Interrater variability of sleep stage scorings has an essential impact not only on the reading of polysomnographic sleep studies (PSGs) for clinical trials but also on the evaluation of patients' sleep. With the introduction of a new standard for sleep stage scorings (AASM standard) there is a need for studies on interrater reliability (IRR). The SIESTA database resulting from an EU-funded project provides a large number of studies (n = 72; 56 healthy controls and 16 subjects with different sleep disorders, mean age +/- SD: 57.7 +/- 18.7, 34 females) for which scorings according to both standards (AASM and R&K) were done. Differences in IRR were analysed at two levels: (1) based on quantitative sleep parameter by means of intraclass correlations; and (2) based on an epoch-by-epoch comparison by means of Cohen's kappa and Fleiss' kappa. The overall agreement was for the AASM standard 82.0% (Cohen's kappa = 0.76) and for the R&K standard 80.6% (Cohen's kappa = 0.68). Agreements increased from R&K to AASM for all sleep stages, except N2. The results of this study underline that the modification of the scoring rules improve IRR as a result of the integration of occipital, central and frontal leads on the one hand, but decline IRR on the other hand specifically for N2, due to the new rule that cortical arousals with or without concurrent increase in submental electromyogram are critical events for the end of N2.

DeepSleepNet: A Model for Automatic Sleep Stage Scoring Based on Raw Single-Channel EEG.

PubMed

Supratak, Akara; Dong, Hao; Wu, Chao; Guo, Yike

2017-11-01

This paper proposes a deep learning model, named DeepSleepNet, for automatic sleep stage scoring based on raw single-channel EEG. Most of the existing methods rely on hand-engineered features, which require prior knowledge of sleep analysis. Only a few of them encode the temporal information, such as transition rules, which is important for identifying the next sleep stages, into the extracted features. In the proposed model, we utilize convolutional neural networks to extract time-invariant features, and bidirectional-long short-term memory to learn transition rules among sleep stages automatically from EEG epochs. We implement a two-step training algorithm to train our model efficiently. We evaluated our model using different single-channel EEGs (F4-EOG (left), Fpz-Cz, and Pz-Oz) from two public sleep data sets, that have different properties (e.g., sampling rate) and scoring standards (AASM and R&K). The results showed that our model achieved similar overall accuracy and macro F1-score (MASS: 86.2%-81.7, Sleep-EDF: 82.0%-76.9) compared with the state-of-the-art methods (MASS: 85.9%-80.5, Sleep-EDF: 78.9%-73.7) on both data sets. This demonstrated that, without changing the model architecture and the training algorithm, our model could automatically learn features for sleep stage scoring from different raw single-channel EEGs from different data sets without utilizing any hand-engineered features.

Propensity score analysis with partially observed covariates: How should multiple imputation be used?

PubMed

Leyrat, Clémence; Seaman, Shaun R; White, Ian R; Douglas, Ian; Smeeth, Liam; Kim, Joseph; Resche-Rigon, Matthieu; Carpenter, James R; Williamson, Elizabeth J

2017-01-01

Inverse probability of treatment weighting is a popular propensity score-based approach to estimate marginal treatment effects in observational studies at risk of confounding bias. A major issue when estimating the propensity score is the presence of partially observed covariates. Multiple imputation is a natural approach to handle missing data on covariates: covariates are imputed and a propensity score analysis is performed in each imputed dataset to estimate the treatment effect. The treatment effect estimates from each imputed dataset are then combined to obtain an overall estimate. We call this method MIte. However, an alternative approach has been proposed, in which the propensity scores are combined across the imputed datasets (MIps). Therefore, there are remaining uncertainties about how to implement multiple imputation for propensity score analysis: (a) should we apply Rubin's rules to the inverse probability of treatment weighting treatment effect estimates or to the propensity score estimates themselves? (b) does the outcome have to be included in the imputation model? (c) how should we estimate the variance of the inverse probability of treatment weighting estimator after multiple imputation? We studied the consistency and balancing properties of the MIte and MIps estimators and performed a simulation study to empirically assess their performance for the analysis of a binary outcome. We also compared the performance of these methods to complete case analysis and the missingness pattern approach, which uses a different propensity score model for each pattern of missingness, and a third multiple imputation approach in which the propensity score parameters are combined rather than the propensity scores themselves (MIpar). Under a missing at random mechanism, complete case and missingness pattern analyses were biased in most cases for estimating the marginal treatment effect, whereas multiple imputation approaches were approximately unbiased as long as the outcome was included in the imputation model. Only MIte was unbiased in all the studied scenarios and Rubin's rules provided good variance estimates for MIte. The propensity score estimated in the MIte approach showed good balancing properties. In conclusion, when using multiple imputation in the inverse probability of treatment weighting context, MIte with the outcome included in the imputation model is the preferred approach.

Games as Formative Assessment Environments: Examining the Impact of Explanations of Scoring and Incentives on Math Learning, Game Performance, and Help Seeking. CRESST Report 796

ERIC Educational Resources Information Center

Delacruz, Girlie C.

2011-01-01

Due to their motivational nature, there has been growing interest in the potential of games to help teach academic content and skills. This report examines how different levels of detail about a game's scoring rules affect math learning and performance. Data were collected from 164 students in the fourth to sixth grades at five after-school…

A Chaotic Home Environment Accounts for the Association between Respect for Rules Disposition and Reading Comprehension: A Twin Study

PubMed Central

Taylor, Jeanette; Hart, Sara A.

2014-01-01

This study examined the association between socioemotional dispositions from the developmental propensity model and reading comprehension and whether those associations could be accounted for by level of chaos in the home. Data from 342 monozygotic and 333 same-sex dizygotic twin pairs age 7-13 years were used. A parent rated the twins on sympathy, respect for rules, negative emotionality, and daring and level of chaos in the twins’ home. Reading comprehension was measured using a state-wide school assessment. Only respect for rules significantly and uniquely predicted reading comprehension. Biometric models indicated that respect for rules was positively associated with reading comprehension via the shared environment and home chaos accounted for a significant amount of that shared environmental variance even after controlling for family income. Children with higher respect for rules have better reading comprehension scores in school and this relationship owes partly to the level of chaos in the family home. PMID:25328362

Validation of the CORB75 (confusion, oxygen saturation, respiratory rate, blood pressure, and age ≥ 75 years) as a simpler pneumonia severity rule.

PubMed

Ochoa-Gondar, O; Vila-Corcoles, A; Rodriguez-Blanco, T; Hospital, I; Salsench, E; Ansa, X; Saun, N

2014-04-01

This study compares the ability of two simpler severity rules (classical CRB65 vs. proposed CORB75) in predicting short-term mortality in elderly patients with community-acquired pneumonia (CAP). A population-based study was undertaken involving 610 patients ≥ 65 years old with radiographically confirmed CAP diagnosed between 2008 and 2011 in Tarragona, Spain (350 cases in the derivation cohort, 260 cases in the validation cohort). Severity rules were calculated at the time of diagnosis, and 30-day mortality was considered as the dependent variable. The area under the receiver operating characteristic curves (AUC) was used to compare the discriminative power of the severity rules. Eighty deaths (46 in the derivation and 34 in the validation cohorts) were observed, which gives a mortality rate of 13.1 % (15.6 % for hospitalized and 3.3 % for outpatient cases). After multivariable analyses, besides CRB (confusion, respiration rate ≥ 30/min, systolic blood pressure <90 mmHg or diastolic ≤ 60 mmHg), peripheral oxygen saturation (≤ 90 %) and age ≥ 75 years appeared to be associated with increasing 30-day mortality in the derivation cohort. The model showed adequate calibration for the derivation and validation cohorts. A modified CORB75 scoring system (similar to the classical CRB65, but adding oxygen saturation and increasing the age to 75 years) was constructed. The AUC statistics for predicting mortality in the derivation and validation cohorts were 0.79 and 0.82, respectively. In the derivation cohort, a CORB75 score ≥ 2 showed 78.3 % sensitivity and 65.5 % specificity for mortality (in the validation cohort, these were 82.4 and 71.7 %, respectively). The proposed CORB75 scoring system has good discriminative power in predicting short-term mortality among elderly people with CAP, which supports its use for severity assessment of these patients in primary care.

Circularly polarized Raman study on diamond structure crystals

NASA Astrophysics Data System (ADS)

Lee, Je-Ho; Kim, Sera; Seong, Maeng-Je

2018-01-01

Circularly polarized Raman and/or photoluminescence (PL) analyses have recently been very important in studying physical properties of many layered materials that were either mechanically exfoliated or grown by chemical-vapor-deposition (CVD) on silicon substrates. Since silicon Raman signal is always accompanied by the circularly polarized Raman and/or PL signal from the layered materials, observation of proper circularly polarized Raman selection rules on silicon substrates would be extremely good indicator that the circularly polarized Raman and/or PL measurements on the layered materials were done properly. We have performed circularly polarized Raman measurements on silicon substrates and compared the results with the Raman intensities calculated by using Raman tensors of the diamond crystal structure. Our experimental results were in excellent agreement with the calculation. Similar circularly polarized Raman analysis done on germanium substrate also showed good agreement.

Coreference analysis in clinical notes: a multi-pass sieve with alternate anaphora resolution modules

PubMed Central

Li, Dingcheng; Sohn, Sunghwan; Wu, Stephen Tze-Inn; Wagholikar, Kavishwar; Torii, Manabu; Liu, Hongfang

2012-01-01

Objective This paper describes the coreference resolution system submitted by Mayo Clinic for the 2011 i2b2/VA/Cincinnati shared task Track 1C. The goal of the task was to construct a system that links the markables corresponding to the same entity. Materials and methods The task organizers provided progress notes and discharge summaries that were annotated with the markables of treatment, problem, test, person, and pronoun. We used a multi-pass sieve algorithm that applies deterministic rules in the order of preciseness and simultaneously gathers information about the entities in the documents. Our system, MedCoref, also uses a state-of-the-art machine learning framework as an alternative to the final, rule-based pronoun resolution sieve. Results The best system that uses a multi-pass sieve has an overall score of 0.836 (average of B3, MUC, Blanc, and CEAF F score) for the training set and 0.843 for the test set. Discussion A supervised machine learning system that typically uses a single function to find coreferents cannot accommodate irregularities encountered in data especially given the insufficient number of examples. On the other hand, a completely deterministic system could lead to a decrease in recall (sensitivity) when the rules are not exhaustive. The sieve-based framework allows one to combine reliable machine learning components with rules designed by experts. Conclusion Using relatively simple rules, part-of-speech information, and semantic type properties, an effective coreference resolution system could be designed. The source code of the system described is available at https://sourceforge.net/projects/ohnlp/files/MedCoref. PMID:22707745

Exercise dependence score in patients with longstanding eating disorders and controls: the importance of affect regulation and physical activity intensity.

PubMed

Bratland-Sanda, Solfrid; Martinsen, Egil W; Rosenvinge, Jan H; Rø, Oyvind; Hoffart, Asle; Sundgot-Borgen, Jorunn

2011-01-01

To examine associations among exercise dependence score, amount of physical activity and eating disorder (ED) symptoms in patients with longstanding ED and non-clinical controls. Adult female inpatients (n = 59) and 53 age-matched controls participated in this cross sectional study. Assessments included the eating disorders examination, eating disorders inventory, exercise dependence scale, reasons for exercise inventory, and MTI Actigraph accelerometer. Positive associations were found among vigorous, not moderate, physical activity, exercise dependence score and ED symptoms in patients. In the controls, ED symptoms were negatively associated with vigorous physical activity and not correlated with exercise dependence score. Exercise for negative affect regulation, not weight/appearance, and amount of vigorous physical activity were explanatory variables for exercise dependence score in both groups. The positive associations among exercise dependence score, vigorous physical activity and ED symptoms need proper attention in the treatment of longstanding ED. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

Design Characteristics Influence Performance of Clinical Prediction Rules in Validation: A Meta-Epidemiological Study

PubMed Central

Ban, Jong-Wook; Emparanza, José Ignacio; Urreta, Iratxe; Burls, Amanda

2016-01-01

Background Many new clinical prediction rules are derived and validated. But the design and reporting quality of clinical prediction research has been less than optimal. We aimed to assess whether design characteristics of validation studies were associated with the overestimation of clinical prediction rules’ performance. We also aimed to evaluate whether validation studies clearly reported important methodological characteristics. Methods Electronic databases were searched for systematic reviews of clinical prediction rule studies published between 2006 and 2010. Data were extracted from the eligible validation studies included in the systematic reviews. A meta-analytic meta-epidemiological approach was used to assess the influence of design characteristics on predictive performance. From each validation study, it was assessed whether 7 design and 7 reporting characteristics were properly described. Results A total of 287 validation studies of clinical prediction rule were collected from 15 systematic reviews (31 meta-analyses). Validation studies using case-control design produced a summary diagnostic odds ratio (DOR) 2.2 times (95% CI: 1.2–4.3) larger than validation studies using cohort design and unclear design. When differential verification was used, the summary DOR was overestimated by twofold (95% CI: 1.2 -3.1) compared to complete, partial and unclear verification. The summary RDOR of validation studies with inadequate sample size was 1.9 (95% CI: 1.2 -3.1) compared to studies with adequate sample size. Study site, reliability, and clinical prediction rule was adequately described in 10.1%, 9.4%, and 7.0% of validation studies respectively. Conclusion Validation studies with design shortcomings may overestimate the performance of clinical prediction rules. The quality of reporting among studies validating clinical prediction rules needs to be improved. PMID:26730980

Det Norske Veritas rule philosophy with regard to gas turbines for marine propulsion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martin, P.

1999-04-01

This paper is mainly based on Det Norske Veritas (DNV) Rules of January 1996, Part 4, Chapter 2, Section 4 -- Gas Turbines, and is intended to at least open the dialogue between the gas turbine industry and DNV. There is a need for design approval and manufacturing inspection process systematic and testing procedures to match the standards of the industry. The role and expectations imposed by owners, the authorities, insurance agencies, etc. needs to be understood. These expectations often have technical implications that may go against the normal procedures and practices of the gas turbine industry, and could havemore » cost impacts. The question of DNV acceptance criteria has been asked many times, with respect to gas turbines. DNV relies a great deal on the manufacturer to provide the basis for the design criteria, manufacturing, and testing criteria of the gas turbine. However, DNV adds its knowledge and experience to this, and checks that the documentation presented by the manufacturer is technically acceptable. Generally, a high level of the state-of-the-art theoretical documentation is required to support the design of modern gas turbines. A proper understanding of the rule philosophy of DNV could prove to be useful in developing better gas turbines systems, which fulfill the rule requirements, and at the same time save resources such as money and time. It is important for gas turbine manufacturers to understand the intent of the rules since it is the intent that needs to be fulfilled. Further, the rules do have the principle of equivalence, which means that there is full freedom in how one fulfills the intent of the rules, as long as DNV accepts the solution.« less

Conformance Testing: Measurement Decision Rules

NASA Technical Reports Server (NTRS)

Mimbs, Scott M.

2010-01-01

The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to provide assurance to the customer that end products meet specifications. Measuring devices, often called measuring and test equipment (MTE), are used to provide the evidence of product conformity to specified requirements. Unfortunately, processes that employ MTE can become a weak link to the overall QMS if proper attention is not given to the measurement process design, capability, and implementation. Documented "decision rules" establish the requirements to ensure measurement processes provide the measurement data that supports the needs of the QMS. Measurement data are used to make the decisions that impact all areas of technology. Whether measurements support research, design, production, or maintenance, ensuring the data supports the decision is crucial. Measurement data quality can be critical to the resulting consequences of measurement-based decisions. Historically, most industries required simplistic, one-size-fits-all decision rules for measurements. One-size-fits-all rules in some cases are not rigorous enough to provide adequate measurement results, while in other cases are overly conservative and too costly to implement. Ideally, decision rules should be rigorous enough to match the criticality of the parameter being measured, while being flexible enough to be cost effective. The goal of a decision rule is to ensure that measurement processes provide data with a sufficient level of quality to support the decisions being made - no more, no less. This paper discusses the basic concepts of providing measurement-based evidence that end products meet specifications. Although relevant to all measurement-based conformance tests, the target audience is the MTE end-user, which is anyone using MTE other than calibration service providers. Topics include measurement fundamentals, the associated decision risks, verifying conformance to specifications, and basic measurement decisions rules.

Validity of cardiovascular risk prediction models in Latin America and among Hispanics in the United States of America: a systematic review.

PubMed

Cortes-Bergoderi, Mery; Thomas, Randal J; Albuquerque, Felipe N; Batsis, John A; Burdiat, Gerard; Perez-Terzic, Carmen; Trejo-Gutierrez, Jorge; Lopez-Jimenez, Francisco

2012-08-01

To assess the use and validity of prediction models to estimate the risk of cardiovascular disease (CVD) in Latin America and among Hispanic populations in the United States of America. This was a systematic review of three databases: Ovid MEDLINE (1 January 1950-15 April 2010), LILACS (1 January 1988-15 April 2010), and EMBASE (1 January 1988-15 April 2010). MeSH search terms and domains were related to CVD, prediction rules, Latin America (including the Caribbean), and Hispanics in the United States. Database searches were supplemented by correspondence with experts in the field. A total of 1 655 abstracts were identified, of which five cohorts with a total of 13 142 subjects met inclusion criteria. A Mexican cohort showed that the predicted/observed event-rate ratio for coronary heart disease (CHD) according to the Framingham risk score (FRS) was 1.68 (95% CI, 1.26-2.11); incident myocardial infarction, 1.36 (95% CI, 0.90-1.83); and CHD death, 1.21 (95% CI, 0.43-2.00). In Ecuador, a prediction model for CVD and total deaths in hypertensive patients had an area under the curve (AUC) of 0.79 (95% CI, 0.72-0.86), while the World Health Organization method had an AUC of 0.74 (95% CI, 0.67-0.82). A study predicting mortality risk in people with Chagas' disease had an AUC of 0.81 (95% CI, 0.72-0.90). Among a United State s cohort that included Hispanics, FRS overestimated CVD risk for Hispanics with an AUC of 0.69. Another study in the United States that assessed FRS factors predicting CVD death among Mexican-Americans had an AUC of 0.78. The evidence regarding CVD risk prediction rules in Latin America or among Hispanics in the United States is modest at best. It is likely that the FRS overestimates CVD risk in Hispanics when not properly recalibrated.

Dynamic, Dogmatic, & Divergent: How United States Marine Corps Officers Learn the Innovative Art of Constructive Rule-Breaking

DTIC Science & Technology

2014-07-16

been properly screened and evaluated, and certified as possessing exemplary moral character. Any decision-making construct that knowingly and...to generate optimal outcomes in the grip of chaos.34 In his book Corps Business (2000), David Freeman isolates this idea even further: What sets...and Robb Webb, Battle Ready, Pg. 142. 35 Freedman, David H., Corps Business : The 30 Management Principles of the U.S. Marines, Pg. 68. 36 Interview

The Development of an Expert System for the Creative Design of Mechanisms

DTIC Science & Technology

1989-06-26

adjacelnt Link-1 Figue 41 B.Semntc newr-bae knowlede representto cee 25 4.3 Planning Control in Mechanism Design In a "plain", rule-based expert system...the contracted level, ensures the non-crossing feature. 2. Geometrical: handled at the monochrome level, manages the approximate size of links. 3...Ornamental: handled at the colored level, manages proper orientations between binary links and other miscellaneous appearance of the sketch. Each stage

Restrictions on workplace romance and consensual relationship policies.

PubMed

Gregg, Robert E

2004-01-01

The workplace is frequently the site of romantic and consensual relationships. These relations may sometimes be deemed by employers to infringe on the proper conduct of business and prompt them to adopt rules that limit such interactions. This article explores some of the rights of employees and the possible policies that employers may realistically adopt within the confines of federal and state constitutional statutes, in light of court precedent and in keeping with possible union contract.

Analysing the New Taliban Code of Conduct (Layeha): An Assessment of Changing Perspectives and Strategies of the Afghan Taliban

DTIC Science & Technology

2012-03-01

Regarding Spies; 4. Enemy’s Logistics and Construction Activities; 5. Captured Enemy Equipment (War Booty ); 6. Regarding Commissions (i.e., Mujahedeen...Ordering fighters to blend in with the local population † Properly dividing war booty † Construction and logistics activities † Decision making on captured...detailed rules for pris- oners, the creation of provincial commissions and dividing war booty ) – also warrants a close examination. Actions prohibited by

JPRS Report, Science & Technology, USSR: Materials Science, Mechanics and Technology of Metal and Metal Ceramic Composite Material Products

DTIC Science & Technology

1990-09-27

value computed according to an additive rule [1], while on the other hand inelastic ( microplastic ) deformation starts earlier (practically at aw -* 0...and transverse directions. The development of microplastic zones in the matrix and their influence on macroscopic proper- ties are illustrated... microplastic zones starts at the phase interface, while in titanium-boron composites it starts at some distance from the interface. In the first case the

Day in, Day out

ERIC Educational Resources Information Center

Frazier, Mary Claire

2006-01-01

Some persuasive research over the past decade shows a strong relationship between the availability of daylight in classrooms and increased test scores for students. Schools seeking to apply that research to actual school construction projects face several hurdles, but the benefits can be real and long-lasting. A properly installed, calibrated and…

Predictors of Very Low Adherence with Medications for Osteoporosis: Towards Development of a Clinical Prediction Rule

PubMed Central

Solomon, Daniel H.; Brookhart, M. Alan; Tsao, Peter; Sundaresan, Devi; Andrade, Susan E.; Mazor, Kathleen; Yood, Robert

2016-01-01

Background Medication non-adherence is extremely common for osteoporosis, however no clear methods exist for identifying patients at-risk of this behavior. We developed a clinical prediction rule to predict medication non-adherence for women prescribed osteoporosis treatment. Methods Women undergoing bone mineral density testing and fulfilling WHO criteria for osteoporosis were invited to complete a questionnaire and then followed for one year. Adjusted logistic regression models were examined to identify variables associated with very low adherence (medication possession ratio < 20%). The weighted variables, based on the logistic regression, were summed and the score compared with the proportion of subjects with very low adherence. Results 142 women participated in the questionnaire and were prescribed an osteoporosis medication. After one year, 36% (n = 50) had very low adherence. Variables associated with very low adherence included: prior non-adherence with chronic medications, agreement that side effects are concerning, agreement that she is taking too many medications, lack of agreement that osteoporosis is a worry, lack of agreement that a fracture will cause disability, lack of agreement that medications help her stay active, and frequent use of alcohol. When combined into a summative score, 36 of the 58 subjects (62%) with 7 or more points on the score demonstrated very low adherence. This compares with 14 of the 84 (17%) subjects with fewer than 7 points (c-statistic = 0.74). Conclusions We developed a brief clinical prediction rule that was able to discriminate between women likely (and unlikely) to experience very low adherence with osteoporosis medications. PMID:20878392

Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score.

PubMed

Aalbers, Jolien; O'Brien, Kirsty K; Chan, Wai-Sun; Falk, Gavin A; Teljeur, Conor; Dimitrov, Borislav D; Fahey, Tom

2011-06-01

Stratifying patients with a sore throat into the probability of having an underlying bacterial or viral cause may be helpful in targeting antibiotic treatment. We sought to assess the diagnostic accuracy of signs and symptoms and validate a clinical prediction rule (CPR), the Centor score, for predicting group A β-haemolytic streptococcal (GABHS) pharyngitis in adults (> 14 years of age) presenting with sore throat symptoms. A systematic literature search was performed up to July 2010. Studies that assessed the diagnostic accuracy of signs and symptoms and/or validated the Centor score were included. For the analysis of the diagnostic accuracy of signs and symptoms and the Centor score, studies were combined using a bivariate random effects model, while for the calibration analysis of the Centor score, a random effects model was used. A total of 21 studies incorporating 4,839 patients were included in the meta-analysis on diagnostic accuracy of signs and symptoms. The results were heterogeneous and suggest that individual signs and symptoms generate only small shifts in post-test probability (range positive likelihood ratio (+LR) 1.45-2.33, -LR 0.54-0.72). As a decision rule for considering antibiotic prescribing (score ≥ 3), the Centor score has reasonable specificity (0.82, 95% CI 0.72 to 0.88) and a post-test probability of 12% to 40% based on a prior prevalence of 5% to 20%. Pooled calibration shows no significant difference between the numbers of patients predicted and observed to have GABHS pharyngitis across strata of Centor score (0-1 risk ratio (RR) 0.72, 95% CI 0.49 to 1.06; 2-3 RR 0.93, 95% CI 0.73 to 1.17; 4 RR 1.14, 95% CI 0.95 to 1.37). Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The Centor score is a well calibrated CPR for estimating the probability of GABHS pharyngitis. The Centor score can enhance appropriate prescribing of antibiotics, but should be used with caution in low prevalence settings of GABHS pharyngitis such as primary care.

Mixture EMOS model for calibrating ensemble forecasts of wind speed.

PubMed

Baran, S; Lerch, S

2016-03-01

Ensemble model output statistics (EMOS) is a statistical tool for post-processing forecast ensembles of weather variables obtained from multiple runs of numerical weather prediction models in order to produce calibrated predictive probability density functions. The EMOS predictive probability density function is given by a parametric distribution with parameters depending on the ensemble forecasts. We propose an EMOS model for calibrating wind speed forecasts based on weighted mixtures of truncated normal (TN) and log-normal (LN) distributions where model parameters and component weights are estimated by optimizing the values of proper scoring rules over a rolling training period. The new model is tested on wind speed forecasts of the 50 member European Centre for Medium-range Weather Forecasts ensemble, the 11 member Aire Limitée Adaptation dynamique Développement International-Hungary Ensemble Prediction System ensemble of the Hungarian Meteorological Service, and the eight-member University of Washington mesoscale ensemble, and its predictive performance is compared with that of various benchmark EMOS models based on single parametric families and combinations thereof. The results indicate improved calibration of probabilistic and accuracy of point forecasts in comparison with the raw ensemble and climatological forecasts. The mixture EMOS model significantly outperforms the TN and LN EMOS methods; moreover, it provides better calibrated forecasts than the TN-LN combination model and offers an increased flexibility while avoiding covariate selection problems. © 2016 The Authors Environmetrics Published by JohnWiley & Sons Ltd.

Hidden patterns of reciprocity.

PubMed

Syi

2014-03-21

Reciprocity can help the evolution of cooperation. To model both types of reciprocity, we need the concept of strategy. In the case of direct reciprocity there are four second-order action rules (Simple Tit-for-tat, Contrite Tit-for-tat, Pavlov, and Grim Trigger), which are able to promote cooperation. In the case of indirect reciprocity the key component of cooperation is the assessment rule. There are, again, four elementary second-order assessment rules (Image Scoring, Simple Standing, Stern Judging, and Shunning). The eight concepts can be formalized in an ontologically thin way we need only an action predicate and a value function, two agent concepts, and the constant of goodness. The formalism helps us to discover that the action and assessment rules can be paired, and that they show the same patterns. The logic of these patterns can be interpreted with the concept of punishment that has an inherent paradoxical nature. Copyright © 2013 Elsevier Ltd. All rights reserved.

A protocol for the Hamilton Rating Scale for Depression: Item scoring rules, Rater training, and outcome accuracy with data on its application in a clinical trial.

PubMed

Rohan, Kelly J; Rough, Jennifer N; Evans, Maggie; Ho, Sheau-Yan; Meyerhoff, Jonah; Roberts, Lorinda M; Vacek, Pamela M

2016-08-01

We present a fully articulated protocol for the Hamilton Rating Scale for Depression (HAM-D), including item scoring rules, rater training procedures, and a data management algorithm to increase accuracy of scores prior to outcome analyses. The latter involves identifying potentially inaccurate scores as interviews with discrepancies between two independent raters on the basis of either scores >=5-point difference) or meeting threshold for depression recurrence status, a long-term treatment outcome with public health significance. Discrepancies are resolved by assigning two new raters, identifying items with disagreement per an algorithm, and reaching consensus on the most accurate scores for those items. These methods were applied in a clinical trial where the primary outcome was the Structured Interview Guide for the Hamilton Rating Scale for Depression-Seasonal Affective Disorder version (SIGH-SAD), which includes the 21-item HAM-D and 8 items assessing atypical symptoms. 177 seasonally depressed adult patients were enrolled and interviewed at 10 time points across treatment and the 2-year followup interval for a total of 1589 completed interviews with 1535 (96.6%) archived. Inter-rater reliability ranged from ICCs of .923-.967. Only 86 (5.6%) interviews met criteria for a between-rater discrepancy. HAM-D items "Depressed Mood", "Work and Activities", "Middle Insomnia", and "Hypochondriasis" and Atypical items "Fatigability" and "Hypersomnia" contributed most to discrepancies. Generalizability beyond well-trained, experienced raters in a clinical trial is unknown. Researchers might want to consider adopting this protocol in part or full. Clinicians might want to tailor it to their needs. Copyright © 2016 Elsevier B.V. All rights reserved.

Assessing self-care and social function using a computer adaptive testing version of the Pediatric Evaluation of Disability Inventory Accepted for Publication, Archives of Physical Medicine and Rehabilitation

PubMed Central

Coster, Wendy J.; Haley, Stephen M.; Ni, Pengsheng; Dumas, Helene M.; Fragala-Pinkham, Maria A.

2009-01-01

Objective To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the Self-Care and Social Function scales of the Pediatric Evaluation of Disability Inventory (PEDI) compared to the full-length version of these scales. Design Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study. Settings Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children’s homes. Participants Four hundred sixty-nine children with disabilities and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). Interventions Not applicable. Main Outcome Measures Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length Self-Care and Social Function scales; time (in seconds) to complete assessments and respondent ratings of burden. Results Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (all r’s between .94 and .99). Using computer simulation of retrospective data, discriminant validity and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared to over 16 minutes to complete the full-length scales. Conclusions Self-care and Social Function score estimates from CAT administration are highly comparable to those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time. PMID:18373991

A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors.

PubMed

Yun, Young Ho; Kim, Young Ae; Lee, Myung Kyung; Sim, Jin Ah; Nam, Byung-Ho; Kim, Sohee; Lee, Eun Sook; Noh, Dong-Young; Lim, Jae-Young; Kim, Sung; Kim, Si-Young; Cho, Chi-Heum; Jung, Kyung Hae; Chun, Mison; Lee, Soon Nam; Park, Kyong Hwa; Park, Sohee

2017-05-02

We aimed to evaluate the potential benefits of the Leadership and Coaching for Health (LEACH) program on physical activity (PA), dietary habits, and distress management in cancer survivors. We randomly assigned 248 cancer survivors with an allocation ratio of two-to-one to the LEACH program (LP) group, coached by long-term survivors, or the usual care (UC) group. At baseline, 3, 6, and 12 months, we used PA scores, the intake of vegetables and fruits (VF), and the Post Traumatic Growth Inventory (PTGI) as primary outcomes and, for secondary outcomes, the Ten Rules for Highly Effective Health Behavior adhered to and quality of life (QOL), the Hospital Anxiety and Depression Scale (HADS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). For primary outcomes, the two groups did not significantly differ in PA scores or VF intake but differed marginally in PTGI. For secondary outcomes, the LP group showed a significantly greater improvement in the HADS anxiety score, the social functioning score, and the appetite loss and financial difficulties scores of the EORTC QLQ-C30 scales from baseline to 3 months. From baseline to 12 months, the LP group showed a significantly greater decrease in the EORTC QLQ-C30 fatigue score and a significantly greater increase in the number of the Ten Rules for Highly Effective Health Behavior. Our findings indicate that the LEACH program, coached by long-term survivors, can provide effective management of the QOL of cancer survivors but not of their PA or dietary habits. Clinical trial information can be found for the following: NCT01527409 (the date when the trial was registered: February 2012).

Effectiveness of first-aid training on school students in Singur Block of Hooghly District, West Bengal.

PubMed

Bandyopadhyay, Lina; Manjula, M; Paul, Bobby; Dasgupta, Aparajita

2017-01-01

First aid is the helping behavior and initial care provided for an acute illness or injury. Students have the potential for changing the health scenario of the society if properly groomed and educated. The objective of the study is to evaluate the effectiveness of educational intervention on the first aid among middle school students of a rural school in West Bengal. A total of 230, 6 th and 7 th standard students were given a self-administered questionnaire for assessing their baseline knowledge about management of common injuries followed by educational intervention with a systematically devised teaching module during February to March 2016. Post intervention evaluation of their knowledge acquisition was done after 2 weeks with same questionnaire. The baseline knowledge on the management of selected injuries was found to be insufficient among the study subjects. Paired t -test was performed to compare the pre- and post-test scores of knowledge and attitude of the students about first aid, and there was a significant change in knowledge from pretest score (mean = 1.50, standard deviation [SD] =0.47) to posttest score (mean = 6.53, SD = 1.30). To quantify the effectiveness of health education, effect size (Cohen's d) was derived. For knowledge score, Cohen's d was 5.14 with large effect size indicating highly effective impact of the training program. Significant change was also noticed regarding attitude regarding first aid as evident from increase in pretest score (mean = 1.19, SD = 0.96) to posttest score (mean = 3.17, SD = 1.03); Cohen's d was 1.88 with medium effect size. Inculcating first-aid training in the school curriculum can be a fruitful investment in ensuring proper and timely management of illnesses and injuries not only for the school children but also for the community at large.

Quantifying risk and benchmarking performance in the adult intensive care unit.

PubMed

Higgins, Thomas L

2007-01-01

Morbidity, mortality, and length-of-stay outcomes in patients receiving critical care are difficult to interpret unless they are risk-stratified for diagnosis, presenting severity of illness, and other patient characteristics. Acuity adjustment systems for adults include the Acute Physiology And Chronic Health Evaluation (APACHE), the Mortality Probability Model (MPM), and the Simplified Acute Physiology Score (SAPS). All have recently been updated and recalibrated to reflect contemporary results. Specialized scores are also available for patient subpopulations where general acuity scores have drawbacks. Demand for outcomes data is likely to grow with pay-for-performance initiatives as well as for routine clinical, prognostic, administrative, and research applications. It is important for clinicians to understand how these scores are derived and how they are properly applied to quantify patient severity of illness and benchmark intensive care unit performance.

Global Security Rule Sets An Analysis of the Current Global Security Environment and Rule Sets Governing Nuclear Weapons Release

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mollahan, K; Nattrass, L

America is in a unique position in its history. In maintaining its position as the world's only superpower, the US consistently finds itself taking on the role of a global cop, chief exporter of hard and soft power, and primary impetus for globalization. A view of the current global situation shows an America that can benefit greatly from the effects of globalization and soft power. Similarly, America's power can be reduced significantly if globalization and its soft power are not handled properly. At the same time, America has slowly come to realize that its next major adversary is not amore » near peer competitor but terrorism and disconnected nations that seek nuclear capabilities. In dealing with this new threat, America needs to come to terms with its own nuclear arsenal and build a security rule set that will establish for the world explicitly what actions will cause the US to consider nuclear weapons release. This rule set; however, needs to be established with sensitivity to the US's international interests in globalization and soft power. The US must find a way to establish its doctrine governing nuclear weapons release without threatening other peaceful nations in the process.« less

Canine and feline obesity: frequently asked questions and their answers.

PubMed

Becvarova, Iveta

2011-11-01

The diagnosis of obesity is simple and warrants intervention because of the association between obesity and increased morbidity. Pet owner commitment, a proper feeding plan, and regular monitoring are the keys to a successful weight loss program. Treatment of obesity involves caloric restriction and/or diet change. Therapeutic weight loss diets differ in fiber, moisture, and digestible carbohydrate contents, and the diet choice should be tailored to the individual patient. Appropriate feeding management is equally important. To protect against the recurrence of obesity, owners should be educated on how to monitor body condition score and adjust the feeding program to maintain proper body condition.

Introducing the Big Knowledge to Use (BK2U) challenge.

PubMed

Perl, Yehoshua; Geller, James; Halper, Michael; Ochs, Christopher; Zheng, Ling; Kapusnik-Uner, Joan

2017-01-01

The purpose of the Big Data to Knowledge initiative is to develop methods for discovering new knowledge from large amounts of data. However, if the resulting knowledge is so large that it resists comprehension, referred to here as Big Knowledge (BK), how can it be used properly and creatively? We call this secondary challenge, Big Knowledge to Use. Without a high-level mental representation of the kinds of knowledge in a BK knowledgebase, effective or innovative use of the knowledge may be limited. We describe summarization and visualization techniques that capture the big picture of a BK knowledgebase, possibly created from Big Data. In this research, we distinguish between assertion BK and rule-based BK (rule BK) and demonstrate the usefulness of summarization and visualization techniques of assertion BK for clinical phenotyping. As an example, we illustrate how a summary of many intracranial bleeding concepts can improve phenotyping, compared to the traditional approach. We also demonstrate the usefulness of summarization and visualization techniques of rule BK for drug-drug interaction discovery. © 2016 New York Academy of Sciences.

Multi-scale Modeling of the Impact Response of a Strain Rate Sensitive High-Manganese Austenitic Steel

NASA Astrophysics Data System (ADS)

Önal, Orkun; Ozmenci, Cemre; Canadinc, Demircan

2014-09-01

A multi-scale modeling approach was applied to predict the impact response of a strain rate sensitive high-manganese austenitic steel. The roles of texture, geometry and strain rate sensitivity were successfully taken into account all at once by coupling crystal plasticity and finite element (FE) analysis. Specifically, crystal plasticity was utilized to obtain the multi-axial flow rule at different strain rates based on the experimental deformation response under uniaxial tensile loading. The equivalent stress - equivalent strain response was then incorporated into the FE model for the sake of a more representative hardening rule under impact loading. The current results demonstrate that reliable predictions can be obtained by proper coupling of crystal plasticity and FE analysis even if the experimental flow rule of the material is acquired under uniaxial loading and at moderate strain rates that are significantly slower than those attained during impact loading. Furthermore, the current findings also demonstrate the need for an experiment-based multi-scale modeling approach for the sake of reliable predictions of the impact response.

Ada Structure Design Language (ASDL)

NASA Technical Reports Server (NTRS)

Chedrawi, Lutfi

1986-01-01

An artist acquires all the necessary tools before painting a scene. In the same analogy, a software engineer needs the necessary tools to provide their design with the proper means for implementation. Ada provide these tools. Yet, as an artist's painting needs a brochure to accompany it for further explanation of the scene, an Ada design also needs a document along with it to show the design in its detailed structure and hierarchical order. Ada could be self-explanatory in small programs not exceeding fifty lines of code in length. But, in a large environment, ranging from thousands of lines and above, Ada programs need to be well documented to be preserved and maintained. The language used to specify an Ada document is called Ada Structure Design Language (ASDL). This language sets some rules to help derive a well formatted Ada detailed design document. The rules are defined to meet the needs of a project manager, a maintenance team, a programmer and a systems designer. The design document templates, the document extractor, and the rules set forth by the ASDL are explained in detail.

Elderly’s Family Life Supplies - Innovative Chinese Checkers Game Board

NASA Astrophysics Data System (ADS)

CHAO, Fanglin

2017-09-01

The product design course for industrial design students was implemented in our university which spans 9 weeks. Throughout the creativity rules and field study, students achieve high standard on problem identification and concept generation. The prototype test with elderly in design projects is helpful to make students with deeper understand user demand, which in turn enhance the concept further. Traditional Chinese checkers are redesigned using special checkers with different height or shape and specific rules to increase user interest and game diversity. Game is more challenging due to location weighting on score calculation to planning its strategies. Redesign Chinese checkers game board include reconfigurable board and several shape checkers. Checkers has 3 parts: standing ring body, the base body, both support the side holding structure. The body shows slightly concave to facilitate the fingers hold. The upper portion of the body is provided with different shapes extension section which can be engaged with base body. Player move the checker to the opposite target area. When one of player moved all the checkers to the opposite target area; they shift to the scoring calculation stage. The participant may develop specific strategy to gain higher score by maximized weighted checkers into its target block regions.

Factors affecting the retrieval of famous names.

PubMed

Martins, Isabel Pavão; Loureiro, Clara; Rodrigues, Susana; Dias, Beatriz; Slade, Peter

2010-06-01

Tests of famous faces are used to study language and memory. Yet, the effect of stimulus properties on performance has not been fully investigated. To identify factors influencing proper name retrieval and to probe stimulus-specific parameters within proper name lexicon, we analysed the results obtained by 300 healthy participants on a test of famous faces that includes 74 personalities. A factor analysis yielded five main factors that were characterized by language (national or foreign names), epoch of peak popularity (current, recent or past) and occupation (politicians, entertainment and sports) of the personalities. Multiple regression analysis showed that participants' education, age and gender accounted for 10-32% of the variance in factor scores. These results indicate that there are variables of the stimulus and participants' that must be taken into account in proper name testing and in designing tests aimed to differentiate age-associated difficulties from cognitive decline.

SYSTEMATIZATION OF MASS LEVELS OF PARTICLES AND RESONANCES ON HEURISTIC BASIS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Takabayasi, T.

1963-12-16

Once more a scheme of simple mass rules and formulas for particles and resonant levels is investigated and organized, based on some general hypotheses. The essential ingredients in the scheme are, on one hand, the equalinterval rule governing the isosinglet meson series, associated with particularly simple mass ratio between the 2/sup ++/ level f and 0/sup ++/ level ABC, and on the other a new basic mass formula that unifies some of the meson and baryon levels. The whole baryon levels are arranged in a table analogous to the periodic table, and then correspondences between different series and equivalence betweenmore » spin and hypercharge, when properly applied, just fix the whole baryon mass spectrum in good agreement with observations. Connections with the scheme of mass formulas formerly given are also shown. (auth)« less

Improving the frequency of visual infusion phlebitis (VIP) scoring on an oncology ward

PubMed Central

Tzolos, Evangelos; Salawu, Abdulazeez

2014-01-01

Phlebitis from peripheral intravenous infusions is an important potential source of oncology patient morbidity. Important factors found to determine phlebitis incidence include the kind of infusion and dwell time of intravenous cannula. Early studies showed incidence rates of between 25–70% worldwide, and association with up to 10% of S. aureus bacteraemia. The introduction of the visual infusion phlebitis (VIP) score tool for assessment of the early signs of phlebitis, along with prompt removal of peripheral intravenous cannulas, has been very successful in reducing the incidence below the acceptable rate of 5%. However, achieving this goal depends on strict compliance with guidelines for cannula insertion, documentation, and assessment using the VIP tool. This study aimed to increase the use of VIP scoring tool to 100% on an oncology ward during a four to six month period in order to maximise its utility in phlebitis prevention. Three plan-do-study-act (PDSA) cycles were carried out, during which two major interventions were introduced. The first cycle aimed to improve junior doctors’ awareness of VIP scoring using presentations in induction meetings and posters. The second cycle ensured that ready access to the VIP tool was provided in the form of bedside intentional rounding charts. Proportions of intravenous cannulas with proper documentation and VIP assessment were measured before intervention and at nine subsequent bi-weekly time points. Pre-intervention, under 30% of cannulas were properly documented and assessed. This proportion rose to around 80% by the end of the second PDSA cycle and achieved 100% by the end of the third cycle. PMID:26734282

Access to nursing education by disabled students: rights and duties of nursing programs.

PubMed

Konur, Ozcan

2002-07-01

This paper outlines the rights and duties of nursing programs regarding access to nursing education for disabled students and the subsequent provision of services for them in the UK. Discussed briefly are the implications of these duties for nursing programs when disabled students are treated less favourably than their peers such as through a failure to make reasonable adjustments within the curriculum. Part IV of the Disability Discrimination Act (1995), as amended by the Special Educational Needs and Disability Act (2001), identifies such statutory duties and rights for nursing programs. For the purpose of this article, access to nursing education by disabled students and the subsequent service provision for these students in nursing programs is described as a game, using a conceptual framework by North. Different roles identified within the formal and informal legal rules, such as attitudes toward disabled students in nursing programs throughout the UK, are discussed briefly using this framework. It is noted that the rules of the game very much mirror the rules under Part II and Part III of the Disability Discrimination Act (1995) relating to disabled employees and disabled service users of public services, in force since December 1996. It is argued that lecturers and senior management teams in both nursing education and the health services occupy historical roles in the efficient design and playing of this game. The next step is to gradually align informal rules with formal rules, which can only be done through proper and correct education of key players.

Validating and updating a prediction rule for serious bacterial infection in patients with fever without source.

PubMed

Bleeker, S E; Derksen-Lubsen, G; Grobbee, D E; Donders, A R T; Moons, K G M; Moll, H A

2007-01-01

To externally validate and update a previously developed rule for predicting the presence of serious bacterial infections in children with fever without apparent source. Patients, 1-36 mo, presenting with fever without source, were prospectively enrolled. Serious bacterial infection included bacterial meningitis, sepsis, bacteraemia, pneumonia, urinary tract infection, bacterial gastroenteritis, osteomyelitis/ethmoiditis. The generalizability of the original rule was determined. Subsequently, the prediction rule was updated using all available data of the patients with fever without source (1996-1998 and 2000-2001, n = 381) using multivariable logistic regression. the generalizability of the rule appeared insufficient in the new patients (n = 150). In the updated rule, independent predictors from history and examination were duration of fever, vomiting, ill clinical appearance, chest-wall retractions and poor peripheral circulation (ROC area (95%CI): 0.69 (0.63-0.75)). Additional independent predictors from laboratory were serum white blood cell count and C-reactive protein, and in urinalysis > or = 70 white bloods (ROC area (95%CI): 0.83 (0.78-0.88). A previously developed prediction rule for predicting the presence of serious bacterial infection in children with fever without apparent source was updated. Its clinical score can be used as a first screening tool. Additional laboratory testing may specify the individual risk estimate (range: 4-54%) further.

The effectiveness of the McIsaac clinical decision rule in the management of sore throat: an evaluation from a pediatrics ward.

PubMed

Thillaivanam, Saravanapriya; Amin, Arwa M; Gopalakrishnan, Sheila; Ibrahim, Baharudin

2016-10-01

Sore throats may be due to either viral or group A beta hemolytic streptococcus (GABHS) infections; but diagnosis of the etiology of a sore throat is difficult, often leading to unnecessary antibiotic prescriptions and consequent increases in bacterial resistance. Scoring symptoms using the McIsaac clinical decision rule can help physicians to diagnose and manage streptococcal infections leading to sore throat and have been recommended by the Ministry of Health, Malaysia. In this paper, we offer the first assessment of the effectiveness of the McIsaac rule in a clinical setting in Malaysia. This study is a retrospective review of 116 pediatric patients presenting with sore throat. Group A comprised patients before the implementation of the McIsaac rule and Group B comprised patients after the implementation. Unnecessary throat swab cultures were reduced by 40% (P = 0.003). Redundant antibiotic prescriptions were reduced by 26.5% (P = 0.003) and the overall use of antibiotics was reduced by 22.1% (P = 0.003). The pediatricians' compliance rate to McIsaac rule criteria was 45% before implementation of the McIsaac rule, but improved to 67.9% (P = 0.0005) after implementation. The McIsaac rule is an effective tool for the management of sore throat in children in Malaysia.

Handbook of Analytical Methods for Textile Composites

NASA Technical Reports Server (NTRS)

Cox, Brian N.; Flanagan, Gerry

1997-01-01

The purpose of this handbook is to introduce models and computer codes for predicting the properties of textile composites. The handbook includes several models for predicting the stress-strain response all the way to ultimate failure; methods for assessing work of fracture and notch sensitivity; and design rules for avoiding certain critical mechanisms of failure, such as delamination, by proper textile design. The following textiles received some treatment: 2D woven, braided, and knitted/stitched laminates and 3D interlock weaves, and braids.

Evaluation of EMERGE, a Medical Decision Making Aid for Analysis of Chest Pain

PubMed Central

Hudson, Donna L.; Cohen, Moses E.; Deedwania, Prakash C.; Watson, Patricia E.

1983-01-01

EMERGE, a rule-based medical decision making aid for analysis of chest pain in the emergency room, was evaluated using retrospective patient data. The analysis consisted of two phases. In the initial phase, patient cases were run in order to make minor modifications and adjustments in the criteria used for determination of admission. In the second phase, patient cases were analyzed to determine the effectiveness of the EMERGE system in arriving at the proper conclusion.

Effects of configuration interaction on photoabsorption spectra in the continuum

NASA Astrophysics Data System (ADS)

Komninos, Yannis; Nicolaides, Cleanthes A.

2004-10-01

It is pointed out that the proper interpretation of a recently published experimental spectrum from the multilaser photoionization of Sr [Eichmann , Phys. Rev. Lett. 90, 233004 (2003)] must account for a radiative transition between two autoionizing states. The application of orthonormality selection rules and of configuration-interaction theory involving the continuous spectrum and the quasicontinuum of the upper part of Rydberg series explains quantitatively the appearance, the shape, and the variation of heights of the observed peaks of resonances.

Duty periods for establishing eligibility for health care. Final rule.

PubMed

2013-12-26

The Department of Veterans Affairs (VA) is amending its medical regulations concerning eligibility for health care to re-establish the definitions of "active military, naval, or air service,'' "active duty,'' and "active duty for training.'' These definitions were deleted in 1996; however, we believe that all duty periods should be defined in part 17 of the Code of Federal Regulations (CFR) to ensure proper determination of eligibility for VA health care. We are also providing a more complete definition of "inactive duty training.''

Applying the take-grant protection model

NASA Technical Reports Server (NTRS)

Bishop, Matt

1990-01-01

The Take-Grant Protection Model has in the past been used to model multilevel security hierarchies and simple protection systems. The models are extended to include theft of rights and sharing information, and additional security policies are examined. The analysis suggests that in some cases the basic rules of the Take-Grant Protection Model should be augmented to represent the policy properly; when appropriate, such modifications are made and their efforts with respect to the policy and its Take-Grant representation are discussed.

COMPUTER TECHNIQUES FOR WEEKLY MULTIPLE-CHOICE TESTING.

ERIC Educational Resources Information Center

BROYLES, DAVID

TO ENCOURAGE POLITICAL SCIENCE STUDENTS TO READ PROPERLY AND CONTINUOUSLY, THE AUTHOR GIVES FREQUENT SHORT QUIZZES BASED ON THE ASSIGNED READINGS. FOR EASE IN ADMINISTRATION AND SCORING, HE USES MARK-SENSE CARDS, ON WHICH THE STUDENT MARKS DESIGNATED AREAS TO INDICATE HIS NUMBER AND HIS CHOICE OF ANSWERS. TO EMPHASIZE THE VALUE OF CONTINUED HIGH…

49 CFR 180.352 - Requirements for retest and inspection of IBCs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... inspections for metal, rigid plastic, and composite IBCs. Each IBC is subject to the following test and... proper examination of the IBC body. (3) Each metal, rigid plastic and composite IBC must be internally... from cuts, tears and punctures. Additionally, fabric must be free from scoring which may render the IBC...

49 CFR 180.352 - Requirements for retest and inspection of IBCs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... inspections for metal, rigid plastic, and composite IBCs. Each IBC is subject to the following test and... proper examination of the IBC body. (3) Each metal, rigid plastic and composite IBC must be internally... from cuts, tears and punctures. Additionally, fabric must be free from scoring which may render the IBC...

49 CFR 180.352 - Requirements for retest and inspection of IBCs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... inspections for metal, rigid plastic, and composite IBCs. Each IBC is subject to the following test and... proper examination of the IBC body. (3) Each metal, rigid plastic and composite IBC must be internally... from cuts, tears and punctures. Additionally, fabric must be free from scoring which may render the IBC...

49 CFR 180.352 - Requirements for retest and inspection of IBCs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... inspections for metal, rigid plastic, and composite IBCs. Each IBC is subject to the following test and... proper examination of the IBC body. (3) Each metal, rigid plastic and composite IBC must be internally... from cuts, tears and punctures. Additionally, fabric must be free from scoring which may render the IBC...

Improving the Validity of Quantitative Measures in Applied Linguistics Research

ERIC Educational Resources Information Center

Purpura, James E.; Brown, James Dean; Schoonen, Rob

2015-01-01

In empirical applied linguistics research it is essential that the key variables are operationalized in a valid and reliable way, and that the scores are treated appropriately, allowing for a proper testing of the hypotheses under investigation. The current article addresses several theoretical and practical issues regarding the use of measurement…

Multimedia Presentations in Educational Measurement and Statistics: Design Considerations and Instructional Approaches

ERIC Educational Resources Information Center

Sklar, Jeffrey C.; Zwick, Rebecca

2009-01-01

Proper interpretation of standardized test scores is a crucial skill for K-12 teachers and school personnel; however, many do not have sufficient knowledge of measurement concepts to appropriately interpret and communicate test results. In a recent four-year project funded by the National Science Foundation, three web-based instructional…

Residency Applicants Misinterpret Their United States Medical Licensing Exam Scores

ERIC Educational Resources Information Center

Jones, Roger C.; Desbiens, Norman A.

2009-01-01

Proper interpretation of the results of the United States Medical Licensing Exam (USMLE) is important for program directors, residents, and faculty who advise applicants about applying for residency positions. We suspected that applicants often misinterpreted their performance in relationship to others who took the same examination. In 2005, 54…

More Than a Matter of Taste: Ensuring Students Eat Right

ERIC Educational Resources Information Center

Ford, Sandra

2013-01-01

Studies have substantiated the link between proper nutrition and success in the classroom and beyond. Research has also found that eating breakfast is associated with improved classroom behavior and higher math, reading, and standardized test scores. Manatee County, Florida offers free breakfast to all students in 14 schools. Many students arrive…

Governance and Intercollegiate Athletics: Boards Must Know the Score

ERIC Educational Resources Information Center

Casteen, John T.; Legon, Richard D.

2012-01-01

While boards have to delegate the daily administration of athletics programs to their presidents, they must be aware of the issues and involve themselves in policy considerations that properly belong to them and can ultimately have a major impact on the institution's financial welfare and reputation. The Knight Commission on Intercollegiate…

Simulating the Effects of Common and Specific Abilities on Test Performance: An Evaluation of Factor Analysis

ERIC Educational Resources Information Center

McFarland, Dennis J.

2014-01-01

Purpose: Factor analysis is a useful technique to aid in organizing multivariate data characterizing speech, language, and auditory abilities. However, knowledge of the limitations of factor analysis is essential for proper interpretation of results. The present study used simulated test scores to illustrate some characteristics of factor…

Practicing medicine in a new environment: what can we learn from the business managers?

PubMed

Frezza, Eldo Ermenegildo; Wachtel, Mitchell S

2006-01-01

Physicians, once only responsible for patient care, now are responsible for their organization's management. Although this paradigm shift occasioned much opposition, most aspects of this change are improving as the rules are reevaluated and reconsidered. Physician managers have difficult tasks for which medical school provides no preparation. Employees must be individually evaluated, so their unique talents can be properly exploited and appropriately compensated. Each person's weaknesses must be improved upon with delicacy, while his or her strengths are given greater and greater focus. This is especially true with regards to billing and coding because the financial health of all healthcare businesses requires organizational competence in this arena. It is vital to have an understanding of each staff member's skills, talents, and knowledge, and a proper deployment of each person into the appropriate job. The goal of any manager is a group of satisfied employees who enjoy their work and make appropriately recognized contributions.

Managing routine food choices in UK families: the role of convenience consumption.

PubMed

Carrigan, Marylyn; Szmigin, Isabelle; Leek, Sheena

2006-11-01

The paper explores the meaning of convenience food for UK mothers, investigating the relationship between mothers and their families' food. The study examines the role of convenience food within the food strategies of contemporary UK families, and aims to elicit consumption meanings in the broader social context of family relationships with food, their rituals, routines and conventions. The findings reveal convenience has multiple meanings for UK women, and that convenience food has been incorporated into reinterpreted versions of homemade and "proper" meals. A hierarchy of acceptable convenience food is presented by the mothers, who tackle complex and conflicting family routines by introducing convenience solutions. Rules of eating have evolved, yet remain essentially controlled by the mother in terms of nutrition. While the traditional model of "proper" food remains aspirational, contemporary family lifestyles require that convenience food become part of the equation.

[Ethical issues in nursing leadership].

PubMed

Wang, Shu-Fang; Hung, Chich-Hsiu

2005-10-01

Social transition causes shifts and changes in the relationship between health professionals and their patients. In their professional capacity, it is important today for nurses to handle ethical dilemmas properly, in a manner that fosters an ethical environment. This article investigates the ethical concerns and decision processes of nurses from a knowledge construction perspective, and examines such issues as patient needs, staff perceptions, organizational benefits, and professional image. The decision making methods commonly used when facing ethical dilemma explored in this study include the traditional problem solving, nursing process, MORAL model, and Murphy's methods. Although decision making for ethical dilemmas is governed by no universal rule, nurses are responsible to try to foster a trusting relationship between employee and employer, health care providers and patients, and the organization and colleagues. When decision making on ethical dilemmas is properly executed quality care will be delivered and malpractice can be reduced.

Nanotoxicity prediction using computational modelling - review and future directions

NASA Astrophysics Data System (ADS)

Saini, Bhavna; Srivastava, Sumit

2018-04-01

Nanomaterials has stimulated various outlooks for future in a number of industries and scientific ventures. A number of applications such as cosmetics, medicines, and electronics are employing nanomaterials due to their various compelling properties. The unending growth of nanomaterials usage in our daily life has escalated the health and environmental risks. Early nanotoxicity recognition is a big challenge. Various researches are going on in the field of nanotoxicity, which comprised of several problems such as inadequacy of proper datasets, lack of appropriate rules and characterization of nanomaterials. Computational modelling would be beneficial asset for nanomaterials researchers because it can foresee the toxicity, rest on previous experimental data. In this study, we have reviewed sufficient work demonstrating a proper pathway to proceed with QSAR analysis of Nanomaterials for toxicity modelling. The paper aims at providing comprehensive insight of Nano QSAR, various theories, tools and approaches used, along with an outline for future research directions to work on.

[Individualized restorative designs and clinical evaluation for dental implants in the anterior esthetic zone with inappropriate conditions].

PubMed

Dai, Wen-yong; Zhou, Guo-xing; Zhang, Xiao-zhen; Zhao, Yi; Wang, Jie; Yang, Yi; Zhu, Zhi-jun; Tang, Chun-bo

2014-08-01

To offer individualized restorative strategies for patients receiving dental implants in the anterior esthetic zone but with inappropriate available conditions and evaluate the clinical outcomes. Forty-six patients with 58 implants were recruited for the study in accordance with the criteria and received individualized implant prostheses in the anterior esthetic zone. The patients were followed up for 3-24 months, and the clinical outcomes were evaluated by pink and white esthetic scores (PES/WES). The patients were from 18 to 69 years old, and followed up for 12.6 months in average. According to the third month follow-up esthetic scores, for PES, 1.72% of the patients got low scores, 44.83% got medium scores and 53.45% got high scores; For WES, 0% got low scores, 20.69% got medium scores and 79.31% got high scores. No implant failure or peri-implantitis occurred. Individualized restorative designs for implants in the esthetic zone can effectively improve the appearance of the prostheses which originally have no appropriate available space. Close follow-up and monitoring of the peri-implant soft tissue and proper oral hygiene instructions are important to ensure the conditions of the prostheses.

The von Neumann model of measurement in quantum mechanics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mello, Pier A.

2014-01-08

We describe how to obtain information on a quantum-mechanical system by coupling it to a probe and detecting some property of the latter, using a model introduced by von Neumann, which describes the interaction of the system proper with the probe in a dynamical way. We first discuss single measurements, where the system proper is coupled to one probe with arbitrary coupling strength. The goal is to obtain information on the system detecting the probe position. We find the reduced density operator of the system, and show how Lüders rule emerges as the limiting case of strong coupling. The vonmore » Neumann model is then generalized to two probes that interact successively with the system proper. Now we find information on the system by detecting the position-position and momentum-position correlations of the two probes. The so-called 'Wigner's formula' emerges in the strong-coupling limit, while 'Kirkwood's quasi-probability distribution' is found as the weak-coupling limit of the above formalism. We show that successive measurements can be used to develop a state-reconstruction scheme. Finally, we find a generalized transform of the state and the observables based on the notion of successive measurements.« less

A clinical prediction rule for detecting major depressive disorder in primary care: the PREDICT-NL study.

PubMed

Zuithoff, Nicolaas P A; Vergouwe, Yvonne; King, Michael; Nazareth, Irwin; Hak, Eelko; Moons, Karel G M; Geerlings, Mirjam I

2009-08-01

Major depressive disorder often remains unrecognized in primary care. Development of a clinical prediction rule using easily obtainable predictors for major depressive disorder in primary care patients. A total of 1046 subjects, aged 18-65 years, were included from seven large general practices in the center of The Netherlands. All subjects were recruited in the general practice waiting room, irrespective of their presenting complaint. Major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Text Revision edition criteria was assessed with the Composite International Diagnostic Interview. Candidate predictors were gender, age, educational level, being single, number of presented complaints, presence of non-somatic complaints, whether a diagnosis was assigned, consultation rate in past 12 months, presentation of depressive complaints or prescription of antidepressants in past 12 months, number of life events in past 6 months and any history of depression. The first multivariable logistic regression model including only predictors that require no confronting depression-related questions had a reasonable degree of discrimination (area under the receiver operating characteristic curve or concordance-statistic (c-statistic) = 0.71; 95% Confidence Interval (CI): 0.67-0.76). Addition of three simple though more depression-related predictors, number of life events and history of depression, significantly increased the c-statistic to 0.80 (95% CI: 0.76-0.83). After transforming this second model to an easily to use risk score, the lowest risk category (sum score < 5) showed a 1% risk of depression, which increased to 49% in the highest category (sum score > or = 30). A clinical prediction rule allows GPs to identify patients-irrespective of their complaints-in whom diagnostic workup for major depressive disorder is indicated.

A clinical score to obviate the need for cardiac stress testing in patients with acute chest pain and negative troponins.

PubMed

Bouzas-Mosquera, Alberto; Peteiro, Jesús; Broullón, Francisco J; Álvarez-García, Nemesio; Maneiro-Melón, Nicolás; Pardo-Martinez, Patricia; Sagastagoitia-Fornie, Marta; Martínez, Dolores; Yáñez, Juan C; Vázquez-Rodríguez, José Manuel

2016-08-01

Although cardiac stress testing may help establish the safety of early discharge in patients with suspected acute coronary syndromes and negative troponins, more cost-effective strategies are necessary. We aimed to develop a clinical prediction rule to safely obviate the need for cardiac stress testing in this setting. A decision rule was derived in a prospective cohort of 3001 patients with acute chest pain and negative troponins, and validated in a set of 1473 subjects. The primary end point was a composite of positive cardiac stress testing (in the absence of a subsequent negative coronary angiogram), positive coronary angiography, or any major coronary events within 3 months. A score chart was built based on 7 variables: male sex (+2), age (+1 per decade from the fifth decade), diabetes mellitus (+2), hypercholesterolemia (+1), prior coronary revascularization (+2), type of chest pain (typical angina, +5; non-specific chest pain, -3), and non-diagnostic repolarization abnormalities (+2). In the validation set, the model showed good discrimination (c statistic = 0.84; 95% confidence interval, 0.82-0.87) and calibration (Hosmer-Lemeshow goodness-of-fit test, P= .34). If stress tests were avoided in patients in the validation sample with a sum score of 0 or lower, the number of referrals would be reduced by 23.4%, yielding a negative predictive value of 98.8% (95% confidence interval, 97.0%-99.7%). This novel prediction rule based on a combination of readily available clinical characteristics may be a valuable tool to decide whether stress testing can be reliably avoided in patients with acute chest pain and negative troponins. Copyright © 2016 Elsevier Inc. All rights reserved.

Continual Screening of Patients Using mHealth: The Rolling Score Concept Applied to Sleep Medicine.

PubMed

Zluga, Claudio; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

2016-01-01

Continual monitoring of patients utilizing mHealth-based telemonitoring applications are more and more used for individual management of patients. A new approach in risk assessment called Rolling Score Concept uses standardized questionnaires for continual scoring of individuals' health state through electronic patient reported outcome (ePRO). Using self-rated questionnaires and adding a specific Time Schedule to each question result in a movement of the questionnaires' scores over time, the Rolling Score. A text-processing pipeline was implemented with KNIME analytics platform to extract a Score Mapping Rule Set for three standardized screening questionnaires in the field of sleep medicine. A feasibility study was performed in 10 healthy volunteers equipped with a mHealth application on a smartphone and a sleep tracker. Results show that the proposed Rolling Score Concept is feasible and deviations of scores are in a reasonable range (< 7%), sustaining the new approach. However, further studies are required for verification. In addition, parameter quantification could avoid incorrect subjective evaluation by substitution of questions with sensor data.

A novel prosodic-information synthesizer based on recurrent fuzzy neural network for the Chinese TTS system.

PubMed

Lin, Chin-Teng; Wu, Rui-Cheng; Chang, Jyh-Yeong; Liang, Sheng-Fu

2004-02-01

In this paper, a new technique for the Chinese text-to-speech (TTS) system is proposed. Our major effort focuses on the prosodic information generation. New methodologies for constructing fuzzy rules in a prosodic model simulating human's pronouncing rules are developed. The proposed Recurrent Fuzzy Neural Network (RFNN) is a multilayer recurrent neural network (RNN) which integrates a Self-cOnstructing Neural Fuzzy Inference Network (SONFIN) into a recurrent connectionist structure. The RFNN can be functionally divided into two parts. The first part adopts the SONFIN as a prosodic model to explore the relationship between high-level linguistic features and prosodic information based on fuzzy inference rules. As compared to conventional neural networks, the SONFIN can always construct itself with an economic network size in high learning speed. The second part employs a five-layer network to generate all prosodic parameters by directly using the prosodic fuzzy rules inferred from the first part as well as other important features of syllables. The TTS system combined with the proposed method can behave not only sandhi rules but also the other prosodic phenomena existing in the traditional TTS systems. Moreover, the proposed scheme can even find out some new rules about prosodic phrase structure. The performance of the proposed RFNN-based prosodic model is verified by imbedding it into a Chinese TTS system with a Chinese monosyllable database based on the time-domain pitch synchronous overlap add (TD-PSOLA) method. Our experimental results show that the proposed RFNN can generate proper prosodic parameters including pitch means, pitch shapes, maximum energy levels, syllable duration, and pause duration. Some synthetic sounds are online available for demonstration.

Non-additive interactions involving two distinct elements mediate sloppy-paired regulation by pair-rule transcription factors

PubMed Central

Prazak, Lisa; Fujioka, Miki; Gergen, J. Peter

2010-01-01

The relatively simple combinatorial rules responsible for establishing the initial metameric expression of sloppy-paired-1 (slp1) in the Drosophila blastoderm embryo make this system an attractive model for investigating the mechanism of regulation by pair rule transcription factors. This investigation of slp1 cis-regulatory architecture identifies two distinct elements, a proximal early stripe element (PESE) and a distal early stripe element (DESE) located from −3.1 kb to −2.5 kb and from −8.1 kb to −7.1 kb upstream of the slp1 promoter, respectively, that mediate this early regulation. The proximal element expresses only even-numbered stripes and mediates repression by Even-skipped (Eve) as well as by the combination of Runt and Fushi-tarazu (Ftz). A 272 basepair sub-element of PESE retains Eve-dependent repression, but is expressed throughout the even-numbered parasegments due to the loss of repression by Runt and Ftz. In contrast, the distal element expresses both odd and even-numbered stripes and also drives inappropriate expression in the anterior half of the odd-numbered parasegments due to an inability to respond to repression by Eve. Importantly, a composite reporter gene containing both early stripe elements recapitulates pair-rule gene-dependent regulation in a manner beyond what is expected from combining their individual patterns. These results indicate interactions involving distinct cis-elements contribute to the proper integration of pair-rule regulatory information. A model fully accounting for these results proposes that metameric slp1 expression is achieved through the Runt-dependent regulation of interactions between these two pair-rule response elements and the slp1 promoter. PMID:20435028

The association between frequency of self-reported medical errors and anesthesia trainee supervision: a survey of United States anesthesiology residents-in-training.

PubMed

De Oliveira, Gildasio S; Rahmani, Rod; Fitzgerald, Paul C; Chang, Ray; McCarthy, Robert J

2013-04-01

Poor supervision of physician trainees can be detrimental not only to resident education but also to patient care and safety. Inadequate supervision has been associated with more frequent deaths of patients under the care of junior residents. We hypothesized that residents reporting more medical errors would also report lower quality of supervision scores than the ones with lower reported medical errors. The primary objective of this study was to evaluate the association between the frequency of medical errors reported by residents and their perceived quality of faculty supervision. A cross-sectional nationwide survey was sent to 1000 residents randomly selected from anesthesiology training departments across the United States. Residents from 122 residency programs were invited to participate, the median (interquartile range) per institution was 7 (4-11). Participants were asked to complete a survey assessing demography, perceived quality of faculty supervision, and perceived causes of inadequate perceived supervision. Responses to the statements "I perform procedures for which I am not properly trained," "I make mistakes that have negative consequences for the patient," and "I have made a medication error (drug or incorrect dose) in the last year" were used to assess error rates. Average supervision scores were determined using the De Oliveira Filho et al. scale and compared among the frequency of self-reported error categories using the Kruskal-Wallis test. Six hundred four residents responded to the survey (60.4%). Forty-five (7.5%) of the respondents reported performing procedures for which they were not properly trained, 24 (4%) reported having made mistakes with negative consequences to patients, and 16 (3%) reported medication errors in the last year having occurred multiple times or often. Supervision scores were inversely correlated with the frequency of reported errors for all 3 questions evaluating errors. At a cutoff value of 3, supervision scores demonstrated an overall accuracy (area under the curve) (99% confidence interval) of 0.81 (0.73-0.86), 0.89 (0.77-0.95), and 0.93 (0.77-0.98) for predicting a response of multiple times or often to the question of performing procedures for which they were not properly trained, reported mistakes with negative consequences to patients, and reported medication errors in the last year, respectively. Anesthesiology trainees who reported a greater incidence of medical errors with negative consequences to patients and drug errors also reported lower scores for supervision by faculty. Our findings suggest that further studies of the association between supervision and patient safety are warranted. (Anesth Analg 2013;116:892-7).

Case Studies in Science Ethics

NASA Astrophysics Data System (ADS)

Williams, Karen

2010-03-01

Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

Topology of three-dimensional separated flows

NASA Technical Reports Server (NTRS)

Tobak, M.; Peake, D. J.

1981-01-01

Based on the hypothesis that patterns of skin-friction lines and external streamlines reflect the properties of continuous vector fields, topology rules define a small number of singular points (nodes, saddle points, and foci) that characterize the patterns on the surface and on particular projections of the flow (e.g., the crossflow plane). The restricted number of singular points and the rules that they obey are considered as an organizing principle whose finite number of elements can be combined in various ways to connect together the properties common to all steady three dimensional viscous flows. Introduction of a distinction between local and global properties of the flow resolves an ambiguity in the proper definition of a three dimensional separated flow. Adoption of the notions of topological structure, structural stability, and bifurcation provides a framework to describe how three dimensional separated flows originate and succeed each other as the relevant parameters of the problem are varied.

Molecular design and synthesis of functional photothermopolymers from hydroxyl benzoic acids

NASA Astrophysics Data System (ADS)

Tong, Xiao; Gu, Jiangnan; Wang, Liyuan; Zou, Yingquan; Yu, Shangxian

2000-06-01

The most applicable hydroxyl benzoic acid monomers were optimized to synthesize the thermolysis-decarboxylation polymers according to the relative results of TG analysis of hydroxyl benzoic acids, their 13C-NMR spectra analyses and their quantum chemistry calculation with AB-INITIO method. On the basis of the empirical rule -- M/A value rule, while phenols with high M/A value and hydroxyl benzoic acids were both cocondensed with formaldehyde at proper ratio, the novolak resin with carboxyl groups used as a thermal imaging material could be obtained. In the presence of an acid catalyst, such as oxalic acid, a hydroxyl benzoic acid could be additionally polymerized with divinyl benzene (DVB) to synthesize another kind of polymer with not only carboxyl groups but also phenolic hydroxyl groups. The thermal imaging mechanisms of these polymers with carboxyl groups were discussed in the paper.

The topological pressure-temperature phase diagram of ritonavir, an extraordinary case of crystalline dimorphism.

PubMed

Céolin, R; Rietveld, I B

2015-01-01

A topological pressure-temperature phase diagram involving the phase relationships of ritonavir forms I and II has been constructed using experimental calorimetric and volumetric data available from the literature. The triple point I-II-liquid is located at a temperature of about 407 K and a pressure as extraordinarily small as 17.5 MPa (175 bar). Thus, the less soluble solid phase (form II) will become metastable on increasing pressure. At room temperature, form I becomes stable around 100 MPa indicating that form II may turn into form I at a relatively low pressure of 1000 bar, which may occur under processing conditions such as mixing or grinding. This case is a good example for which a proper thermodynamic evaluation trumps "rules of thumb" such as the density rule. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Crankshafts: using simple, flat C2h-symmetric molecules to direct the assembly of chiral 2D nanopatterns.

PubMed

Zhou, Hui; Wuest, James D

2013-06-18

Linear D2h-symmetric bisisophthalic acids 1 and 2 and related substances have well-defined flattened structures, high affinities for graphite, and strong abilities to engage in specific intermolecular interactions. Their adsorption produces characteristic nanopatterns that reveal how 2D molecular organization can be controlled by reliable interadsorbate interactions such as hydrogen bonds when properly oriented by molecular geometry. In addition, the behavior of these compounds shows how large-scale organization can be obstructed by programming molecules to associate strongly according to competing motifs that have similar stability and can coexist smoothly without creating significant defects. Analogous new bisisophthalic acids 3a and 4a have similar associative properties, and their unique C2h-symmetric crankshaft geometry gives them the added ability to probe the poorly understood effect of chirality on molecular organization. Their adsorption shows how nanopatterns composed predictably of a single enantiomer can be obtained by depositing molecules that can respect established rules of association only by accepting neighbors of the same configuration. In addition, an analysis of the adsorption of crankshaft compounds 3a and 4a and their derivatives by STM reveals directly on the molecular level how kinetics and thermodynamics compete to control the crystallization of chiral compounds. In such ways, detailed studies of the adsorption of properly designed compounds on surfaces are proving to be a powerful way to discover and test rules that broadly govern molecular organization in both 2D and 3D.

Development of a Computer Adaptive Test for Depression Based on the Dutch-Flemish Version of the PROMIS Item Bank.

PubMed

Flens, Gerard; Smits, Niels; Terwee, Caroline B; Dekker, Joost; Huijbrechts, Irma; de Beurs, Edwin

2017-03-01

We developed a Dutch-Flemish version of the patient-reported outcomes measurement information system (PROMIS) adult V1.0 item bank for depression as input for computerized adaptive testing (CAT). As item bank, we used the Dutch-Flemish translation of the original PROMIS item bank (28 items) and additionally translated 28 U.S. depression items that failed to make the final U.S. item bank. Through psychometric analysis of a combined clinical and general population sample ( N = 2,010), 8 added items were removed. With the final item bank, we performed several CAT simulations to assess the efficiency of the extended (48 items) and the original item bank (28 items), using various stopping rules. Both item banks resulted in highly efficient and precise measurement of depression and showed high similarity between the CAT simulation scores and the full item bank scores. We discuss the implications of using each item bank and stopping rule for further CAT development.

Perfusion lung imaging in the adult respiratory distress syndrome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pistolesi, M.; Miniati, M.; Di Ricco, G.

1986-07-01

In 29 perfusion lung scans (PLS) of 19 patients with ARDS, 20 of which were obtained within six days from the onset of respiratory symptoms, perfusion abnormalities were the rule. These included focal, nonsegmental defects, mostly peripheral and dorsal, and perfusion redistribution away from the dependent lung zones. PLS were scored for the presence and intensity of perfusion abnormalities and the scores of perfusion redistribution were validated against numerical indices of blood flow distribution per unit lung volume. PLS scores were correlated with arterial blood gas values, hemodynamic parameters, and chest radiographic scores of ARDS. Arterial oxygen tension correlated withmore » the scores of both perfusion defects and redistribution. Perfusion defects correlated better with the radiographic score of ARDS, and perfusion redistribution with PAP and vascular resistance. ARDS patients exhibit peculiar patterns of PLS abnormalities not observed in other disorders. Thus, PLS may help considerably in the detection and evaluation of pulmonary vascular injury in ARDS.« less

Fuzzy association rule mining and classification for the prediction of malaria in South Korea.

PubMed

Buczak, Anna L; Baugher, Benjamin; Guven, Erhan; Ramac-Thomas, Liane C; Elbert, Yevgeniy; Babin, Steven M; Lewis, Sheri H

2015-06-18

Malaria is the world's most prevalent vector-borne disease. Accurate prediction of malaria outbreaks may lead to public health interventions that mitigate disease morbidity and mortality. We describe an application of a method for creating prediction models utilizing Fuzzy Association Rule Mining to extract relationships between epidemiological, meteorological, climatic, and socio-economic data from Korea. These relationships are in the form of rules, from which the best set of rules is automatically chosen and forms a classifier. Two classifiers have been built and their results fused to become a malaria prediction model. Future malaria cases are predicted as Low, Medium or High, where these classes are defined as a total of 0-2, 3-16, and above 17 cases, respectively, for a region in South Korea during a two-week period. Based on user recommendations, HIGH is considered an outbreak. Model accuracy is described by Positive Predictive Value (PPV), Sensitivity, and F-score for each class, computed on test data not previously used to develop the model. For predictions made 7-8 weeks in advance, model PPV and Sensitivity are 0.842 and 0.681, respectively, for the HIGH classes. The F0.5 and F3 scores (which combine PPV and Sensitivity) are 0.804 and 0.694, respectively, for the HIGH classes. The overall FARM results (as measured by F-scores) are significantly better than those obtained by Decision Tree, Random Forest, Support Vector Machine, and Holt-Winters methods for the HIGH class. For the Medium class, Random Forest and FARM obtain comparable results, with FARM being better at F0.5, and Random Forest obtaining a higher F3. A previously described method for creating disease prediction models has been modified and extended to build models for predicting malaria. In addition, some new input variables were used, including indicators of intervention measures. The South Korea malaria prediction models predict Low, Medium or High cases 7-8 weeks in the future. This paper demonstrates that our data driven approach can be used for the prediction of different diseases.

Parents' Attitudes and Adherence to Unintentional Injury Prevention Measures in Ankara, Turkey.

PubMed

İnce, Tolga; Yalçın, Songül; Yurdakök, Kadriye

2017-08-04

Childhood unintentional injuries are perceived as a leading public health issue since they are one of the preventable causes of paediatric mortality and morbidity. Whether and how parental factors are related to childhood injury has been researched insufficiently. To investigate parents' attitudes to preventive measures of unintentional childhood injury, and the parental adherence to these measures. Cross-sectional, descriptive study. The data were collected from the parents of children younger than ten years of age admitted to university hospital outpatient clinics for any reason and who agreed to be involved in the study. The first part of the questionnaire included sociodemographic profiles of participating children. Serious injuries were considered to be any injury that requires hospital admission. The second part of the questionnaire was prepared to evaluate parents' adherence to injury prevention rules. A total score calculation about the adherence of the parents to the injury prevention rules was worked out the addition of the scores of each answer given in each age group. Answers for each item given by the parents were scored as wrong (0), sometimes (1) or correct (2). The score for each item was added and the result normalized to 100 points. Only complete questionnaires were used for analysis. A total of 1126 children and parent pairs agreed to participate in the survey. It was found that 13.8% of the participating children had experienced at least one serious injury. Although three-quarters of the parents had received information about injury prevention, the overall injury prevention scores were found to be low. As children's age increased, the total injury prevention scores of parents decreased significantly. Injury prevention scores were shown to increase significantly with high education and maternal occupation. However, scores were shown to decrease significantly with increased child age and family size. Our study shows that parental adherence to the child safety measures aimed at decreasing the unintentional injury risk of children is not satisfactory in Turkey. In particular, parents of 5-9-year-old children, big families (more than five people), parents with less than 8 years of education and non-working mothers should be the main target groups for intervention strategies according to our study results.

Data-Driven Information Extraction from Chinese Electronic Medical Records

PubMed Central

Zhao, Tianwan; Ge, Chen; Gao, Weiguo; Wei, Jia; Zhu, Kenny Q.

2015-01-01

Objective This study aims to propose a data-driven framework that takes unstructured free text narratives in Chinese Electronic Medical Records (EMRs) as input and converts them into structured time-event-description triples, where the description is either an elaboration or an outcome of the medical event. Materials and Methods Our framework uses a hybrid approach. It consists of constructing cross-domain core medical lexica, an unsupervised, iterative algorithm to accrue more accurate terms into the lexica, rules to address Chinese writing conventions and temporal descriptors, and a Support Vector Machine (SVM) algorithm that innovatively utilizes Normalized Google Distance (NGD) to estimate the correlation between medical events and their descriptions. Results The effectiveness of the framework was demonstrated with a dataset of 24,817 de-identified Chinese EMRs. The cross-domain medical lexica were capable of recognizing terms with an F1-score of 0.896. 98.5% of recorded medical events were linked to temporal descriptors. The NGD SVM description-event matching achieved an F1-score of 0.874. The end-to-end time-event-description extraction of our framework achieved an F1-score of 0.846. Discussion In terms of named entity recognition, the proposed framework outperforms state-of-the-art supervised learning algorithms (F1-score: 0.896 vs. 0.886). In event-description association, the NGD SVM is superior to SVM using only local context and semantic features (F1-score: 0.874 vs. 0.838). Conclusions The framework is data-driven, weakly supervised, and robust against the variations and noises that tend to occur in a large corpus. It addresses Chinese medical writing conventions and variations in writing styles through patterns used for discovering new terms and rules for updating the lexica. PMID:26295801

Data-Driven Information Extraction from Chinese Electronic Medical Records.

PubMed

Xu, Dong; Zhang, Meizhuo; Zhao, Tianwan; Ge, Chen; Gao, Weiguo; Wei, Jia; Zhu, Kenny Q

2015-01-01

This study aims to propose a data-driven framework that takes unstructured free text narratives in Chinese Electronic Medical Records (EMRs) as input and converts them into structured time-event-description triples, where the description is either an elaboration or an outcome of the medical event. Our framework uses a hybrid approach. It consists of constructing cross-domain core medical lexica, an unsupervised, iterative algorithm to accrue more accurate terms into the lexica, rules to address Chinese writing conventions and temporal descriptors, and a Support Vector Machine (SVM) algorithm that innovatively utilizes Normalized Google Distance (NGD) to estimate the correlation between medical events and their descriptions. The effectiveness of the framework was demonstrated with a dataset of 24,817 de-identified Chinese EMRs. The cross-domain medical lexica were capable of recognizing terms with an F1-score of 0.896. 98.5% of recorded medical events were linked to temporal descriptors. The NGD SVM description-event matching achieved an F1-score of 0.874. The end-to-end time-event-description extraction of our framework achieved an F1-score of 0.846. In terms of named entity recognition, the proposed framework outperforms state-of-the-art supervised learning algorithms (F1-score: 0.896 vs. 0.886). In event-description association, the NGD SVM is superior to SVM using only local context and semantic features (F1-score: 0.874 vs. 0.838). The framework is data-driven, weakly supervised, and robust against the variations and noises that tend to occur in a large corpus. It addresses Chinese medical writing conventions and variations in writing styles through patterns used for discovering new terms and rules for updating the lexica.

Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation

PubMed Central

Cooney, Rachel M; Warren, Bryan F; Altman, Douglas G; Abreu, Maria T; Travis, Simon PL

2007-01-01

Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking. Thirteen scoring systems have been developed but none have been properly validated. Most trials choose different endpoints and activity indices, making comparison of results from different trials extremely difficult. International consensus on endoscopic, clinical and histological scoring systems is essential as these are the key components used to determine entry criteria and outcome measurements in clinical trials on ulcerative colitis. With multiple new therapies under development, there is a pressing need for consensus to be reached. PMID:17592647

Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score

PubMed Central

2011-01-01

Background Stratifying patients with a sore throat into the probability of having an underlying bacterial or viral cause may be helpful in targeting antibiotic treatment. We sought to assess the diagnostic accuracy of signs and symptoms and validate a clinical prediction rule (CPR), the Centor score, for predicting group A β-haemolytic streptococcal (GABHS) pharyngitis in adults (> 14 years of age) presenting with sore throat symptoms. Methods A systematic literature search was performed up to July 2010. Studies that assessed the diagnostic accuracy of signs and symptoms and/or validated the Centor score were included. For the analysis of the diagnostic accuracy of signs and symptoms and the Centor score, studies were combined using a bivariate random effects model, while for the calibration analysis of the Centor score, a random effects model was used. Results A total of 21 studies incorporating 4,839 patients were included in the meta-analysis on diagnostic accuracy of signs and symptoms. The results were heterogeneous and suggest that individual signs and symptoms generate only small shifts in post-test probability (range positive likelihood ratio (+LR) 1.45-2.33, -LR 0.54-0.72). As a decision rule for considering antibiotic prescribing (score ≥ 3), the Centor score has reasonable specificity (0.82, 95% CI 0.72 to 0.88) and a post-test probability of 12% to 40% based on a prior prevalence of 5% to 20%. Pooled calibration shows no significant difference between the numbers of patients predicted and observed to have GABHS pharyngitis across strata of Centor score (0-1 risk ratio (RR) 0.72, 95% CI 0.49 to 1.06; 2-3 RR 0.93, 95% CI 0.73 to 1.17; 4 RR 1.14, 95% CI 0.95 to 1.37). Conclusions Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The Centor score is a well calibrated CPR for estimating the probability of GABHS pharyngitis. The Centor score can enhance appropriate prescribing of antibiotics, but should be used with caution in low prevalence settings of GABHS pharyngitis such as primary care. PMID:21631919

Diet pattern and longevity: do simple rules suffice? A commentary.

PubMed

Jacobs, David R; Orlich, Michael J

2014-07-01

Nutritionism reduces dietary advice to statements about a few nutrients, with sometimes unintended implications for science, industry, and the public. Although reductionist questions about nutrition are legitimate scientifically, a nutrient focus in the public arena forces the food industry to compete with the use of nutrient statements. Consumers must interpret information that may not be correct or relevant. The theory of food synergy, which postulates that the many constituents of individual foods and dietary patterns act together on health, leads to the idea that dietary policy would be clearer if it focused on foods. To illustrate this method, the food-based A Priori Diet Quality Score was described in the Iowa Women's Health Study; a substantial total mortality reduction for increasing quartiles of the score was found. The simple food-based rules implied in this a priori score support minimizing meat, salt, added sugar, and heavily processed foods while emphasizing phytochemical-rich foods. These principles could help improve nutrition policy, help industry to supply better food, and help to focus future scientific research. Although an understanding of what foods are best for health is a step forward in nutrition, other major challenges remain, including getting high-quality food to the masses and food sustainability. © 2014 American Society for Nutrition.

Trauma scoring systems and databases.

PubMed

Lecky, F; Woodford, M; Edwards, A; Bouamra, O; Coats, T

2014-08-01

This review considers current trauma scoring systems and databases and their relevance to improving patient care. Single physiological measures such as systolic arterial pressure have limited ability to diagnose severe trauma by reflecting raised intracranial pressure, or significant haemorrhage. The Glasgow coma score has the greatest prognostic value in head-injured and other trauma patients. Trauma triage tools and imaging decision rules-using combinations of physiological cut-off measures with mechanism of injury and other categorical variables-bring both increased sophistication and increased complexity. It is important for clinicians and managers to be aware of the diagnostic properties (over- and under-triage rates) of any triage tool or decision rule used in their trauma system. Trauma registries are able to collate definitive injury descriptors and use survival prediction models to guide trauma system governance, through individual patient review and case-mix-adjusted benchmarking of hospital and network performance with robust outlier identification. Interrupted time series allow observation in the changes in care processes and outcomes at national level, which can feed back into clinical quality-based commissioning of healthcare. Registry data are also a valuable resource for trauma epidemiological and comparative effectiveness research studies. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A comparison of item response models for accuracy and speed of item responses with applications to adaptive testing.

PubMed

van Rijn, Peter W; Ali, Usama S

2017-05-01

We compare three modelling frameworks for accuracy and speed of item responses in the context of adaptive testing. The first framework is based on modelling scores that result from a scoring rule that incorporates both accuracy and speed. The second framework is the hierarchical modelling approach developed by van der Linden (2007, Psychometrika, 72, 287) in which a regular item response model is specified for accuracy and a log-normal model for speed. The third framework is the diffusion framework in which the response is assumed to be the result of a Wiener process. Although the three frameworks differ in the relation between accuracy and speed, one commonality is that the marginal model for accuracy can be simplified to the two-parameter logistic model. We discuss both conditional and marginal estimation of model parameters. Models from all three frameworks were fitted to data from a mathematics and spelling test. Furthermore, we applied a linear and adaptive testing mode to the data off-line in order to determine differences between modelling frameworks. It was found that a model from the scoring rule framework outperformed a hierarchical model in terms of model-based reliability, but the results were mixed with respect to correlations with external measures. © 2017 The British Psychological Society.

Segmental intelligibility of synthetic speech produced by rule.

PubMed

Logan, J S; Greene, B G; Pisoni, D B

1989-08-01

This paper reports the results of an investigation that employed the modified rhyme test (MRT) to measure the segmental intelligibility of synthetic speech generated automatically by rule. Synthetic speech produced by ten text-to-speech systems was studied and compared to natural speech. A variation of the standard MRT was also used to study the effects of response set size on perceptual confusions. Results indicated that the segmental intelligibility scores formed a continuum. Several systems displayed very high levels of performance that were close to or equal to scores obtained with natural speech; other systems displayed substantially worse performance compared to natural speech. The overall performance of the best system, DECtalk--Paul, was equivalent to the data obtained with natural speech for consonants in syllable-initial position. The findings from this study are discussed in terms of the use of a set of standardized procedures for measuring intelligibility of synthetic speech under controlled laboratory conditions. Recent work investigating the perception of synthetic speech under more severe conditions in which greater demands are made on the listener's processing resources is also considered. The wide range of intelligibility scores obtained in the present study demonstrates important differences in perception and suggests that not all synthetic speech is perceptually equivalent to the listener.

Segmental intelligibility of synthetic speech produced by rule

PubMed Central

Logan, John S.; Greene, Beth G.; Pisoni, David B.

2012-01-01

This paper reports the results of an investigation that employed the modified rhyme test (MRT) to measure the segmental intelligibility of synthetic speech generated automatically by rule. Synthetic speech produced by ten text-to-speech systems was studied and compared to natural speech. A variation of the standard MRT was also used to study the effects of response set size on perceptual confusions. Results indicated that the segmental intelligibility scores formed a continuum. Several systems displayed very high levels of performance that were close to or equal to scores obtained with natural speech; other systems displayed substantially worse performance compared to natural speech. The overall performance of the best system, DECtalk—Paul, was equivalent to the data obtained with natural speech for consonants in syllable-initial position. The findings from this study are discussed in terms of the use of a set of standardized procedures for measuring intelligibility of synthetic speech under controlled laboratory conditions. Recent work investigating the perception of synthetic speech under more severe conditions in which greater demands are made on the listener’s processing resources is also considered. The wide range of intelligibility scores obtained in the present study demonstrates important differences in perception and suggests that not all synthetic speech is perceptually equivalent to the listener. PMID:2527884

Factors contributing to disability in rheumatoid arthritis patients: An Egyptian multicenter study.

PubMed

Hammad, Marwa; Eissa, Mervat; Dawa, Ghada A

2018-04-30

Minimizing disability and enhancing physical function to its optimal levels is still a challenge in management of rheumatoid arthritis (RA). The aim is to identify factors leading to disability in RA. This is a cross-sectional Egyptian multicenter study carried out on 215 RA patients attending to our inpatient and outpatient rheumatology clinics during 4 months starting from April to July 2017 who agreed to participate in the study; 170 patients were from Cairo University hospitals and 45 from Zagazig University hospitals. We recorded a number of possible risk factors including demographic, clinical, serological and therapeutic factors. The assessment of patients' disability was done using Modified HAQ (MHAQ). A significant positive correlation was found between MHAQ and different markers of activity in addition to age and depression score (P<0.001). Illiteracy accounted for higher MHAQ scores (P=0.001). A higher MHAQ was found in patients with ischemic heart disease (P<0.05). Patients with erosions on X-rays had significantly higher MHAQ scores. Subluxations also accounted for higher MHAQ scores (P=0.000). Aging, illiteracy, disease activity, erosions, subluxations, depression and ischemic heart disease were all related to higher disability. Good control of disease activity which in turn reduces erosions and subluxations is mandatory. Screening for depression and proper use of anti-depressants is of great value. Proper screening and prophylaxis is recommended against ischemic heart disease by controlling modifiable risk factors like obesity, dyslipidaemia, hypertension, smoking and sedentary lifestyle. Copyright © 2018 Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. Publicado por Elsevier España, S.L.U. All rights reserved.

Emergency Physician Attitudes, Preferences, and Risk Tolerance for Stroke as a Potential Cause of Dizziness Symptoms.

PubMed

Kene, Mamata V; Ballard, Dustin W; Vinson, David R; Rauchwerger, Adina S; Iskin, Hilary R; Kim, Anthony S

2015-09-01

We evaluated emergency physicians' (EP) current perceptions, practice, and attitudes towards evaluating stroke as a cause of dizziness among emergency department patients. We administered a survey to all EPs in a large integrated healthcare delivery system. The survey included clinical vignettes, perceived utility of historical and exam elements, attitudes about the value of and requisite post-test probability of a clinical prediction rule for dizziness. We calculated descriptive statistics and post-test probabilities for such a clinical prediction rule. The response rate was 68% (366/535). Respondents' median practice tenure was eight years (37% female, 92% emergency medicine board certified). Symptom quality and typical vascular risk factors increased suspicion for stroke as a cause of dizziness. Most respondents reported obtaining head computed tomography (CT) (74%). Nearly all respondents used and felt confident using cranial nerve and limb strength testing. A substantial minority of EPs used the Epley maneuver (49%) and HINTS (head-thrust test, gaze-evoked nystagmus, and skew deviation) testing (30%); however, few EPs reported confidence in these tests' bedside application (35% and 16%, respectively). Respondents favorably viewed applying a properly validated clinical prediction rule for assessment of immediate and 30-day stroke risk, but indicated it would have to reduce stroke risk to <0.5% to be clinically useful. EPs report relying on symptom quality, vascular risk factors, simple physical exam elements, and head CT to diagnose stroke as the cause of dizziness, but would find a validated clinical prediction rule for dizziness helpful. A clinical prediction rule would have to achieve a 0.5% post-test stroke probability for acceptability.

Child seat belt guidelines: Examining the 4 feet 9 inches rule as the standard.

PubMed

Morse, Amber M; Aitken, Mary E; Mullins, Samantha H; Miller, Beverly K; Pomtree, Mindy M; Ulloa, Erin M; Montgomery, Jeffrey S; Saylors, Marie E

2017-08-01

Current American Academy of Pediatrics recommendations regarding transition from child safety/booster seat to adult safety belt use indicate that children should be at least 4 feet 9 inches, 8 years old, or 80 pounds. Proper fit in the vehicle seat, assessed with a five-point fit test, should also be met. Although most children reach 4 feet 9 inches around age 8 years, each child and vehicle presents a unique combination; thus a child may not fit appropriately in all vehicle types using only the 4 feet 9 inches requirement. We enrolled children, aged 7 years to 12 years, into our study. Height, weight, and demographic data were obtained. A Child Passenger Safety Technician then performed the five-point fit test in each of a uniform lineup of five vehicles. Data were collected on fit in the standard vehicle seat and also in a booster seat. We set 90% as the threshold proportion of children who meet all criteria for proper fit to validate current recommendations of a height of 4 feet 9 inches. Data were collected on 388 children. The percentage of 90% proper fit was met in the compact car and small sport-utility vehicle (SUV). However, only 80 (77%) of 104 students (p < 0.0001) that were 4 feet 9 inches or higher fit properly in the large SUV, only 87 (83%) of 105 students (p = 0.02) fit properly in the pickup truck, and only 91 (89%) of 102 students (p = 0.74) fit properly in the minivan. Substantial proportions of children meeting current height guidelines for an adult seat belt do not meet safety requirements for fit, especially in larger, commonly used vehicles (large SUVs and trucks). This emphasizes the need for evaluation of fit by a trained personnel and/or development of standard back seat dimensions in all vehicles for maximum safety. Epidemiologic study, level III; Therapeutic study, level V.

The Tens Rule in Invasion Biology: Measure of a True Impact or Our Lack of Knowledge and Understanding?

NASA Astrophysics Data System (ADS)

Jarić, I.; Cvijanović, G.

2012-12-01

The Tens Rule, as well as the last stage described therein, i.e., the proportion of established species that becomes pests, is frequently perceived by the scientific community to indicate that introduced established species have little impact on communities. This belief is dangerous because it strengthens the perspective of the general public and decision makers that the risks of species introductions are largely overestimated. It is often difficult to detect the actual negative impact of an introduced established species. It might be less apparent or indirect; it might be delayed or masked by the "noise" caused by other anthropogenic disturbances. It is also likely that numerous ecological interactions are still not detected or properly understood. Therefore, the ten-percent rule might be more of an indicator of our lack of understanding of the impacts that established introduced species produce than the actual ratio of such species that produces negative impacts. In such a state of affairs, adopting the precautionary principle is crucial. The scientific community must be much more cautious and responsible regarding the message it delivers to the general public and management authorities.

The impact of egocentric vs. allocentric agency attributions on the neural bases of reasoning about social rules.

PubMed

Canessa, Nicola; Pantaleo, Giuseppe; Crespi, Chiara; Gorini, Alessandra; Cappa, Stefano F

2014-09-18

We used the "standard" and "switched" social contract versions of the Wason Selection-task to investigate the neural bases of human reasoning about social rules. Both these versions typically elicit the deontically correct answer, i.e. the proper identification of the violations of a conditional obligation. Only in the standard version of the task, however, this response corresponds to the logically correct one. We took advantage of this differential adherence to logical vs. deontical accuracy to test the different predictions of logic rule-based vs. visuospatial accounts of inferential abilities in 14 participants who solved the standard and switched versions of the Selection-task during functional-Magnetic-Resonance-Imaging. Both versions activated the well known left fronto-parietal network of deductive reasoning. The standard version additionally recruited the medial parietal and right inferior parietal cortex, previously associated with mental imagery and with the adoption of egocentric vs. allocentric spatial reference frames. These results suggest that visuospatial processes encoding one's own subjective experience in social interactions may support and shape the interpretation of deductive arguments and/or the resulting inferences, thus contributing to elicit content effects in human reasoning. Copyright © 2014 Elsevier B.V. All rights reserved.

K 4R - Knowledge to the Power of RESTful, Resourceful and Reactive Rules

NASA Astrophysics Data System (ADS)

Amador, Ricardo

The Web of today clearly answers questions of the form "What is the representation of ...?". The Semantic Web (SW) of tomorrow aims at answering questions of the form "What is the meaning of ...?". It is our stance that in order to realize the full potential of the original concept proposed by Tim Berners-Lee et al. (in Scientific American, May 2001), the SW must also answer, in a meaningful way, questions of a dynamic and active nature, like "What to do if ...?" or "What to do when ...?". Moreover, SW questions of the form "What to do ...?" must be expressed and answered in a declarative, compositional and language agnostic way. It is our (hypo)thesis that formally established concepts, viz. the Web's REST architectural style, declarative SW representation of resources based on Description Logics (e.g., OWL-DL), and Reactive Rules (e.g., "on Event if Condition do Action" -ECA- rules), provide the proper theoretical foundations to achieve this goal. This paper describes our current research proposal, K 4R (pronounced, with an Italian flavor, "Che fare?"), towards achieving a declarative model for expressing (re)active behavior in and for the SW.

Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles.

PubMed

Fisher, Steve R; Middleton, Addie; Graham, James E; Ottenbacher, Kenneth J

2018-02-08

To examine how similar summary scores of physical functioning using the FIM can represent different patient clinical profiles. Retrospective cohort study. Inpatient rehabilitation facilities. Medicare fee-for-service beneficiaries (N=765,441) discharged from inpatient rehabilitation. Not applicable. We used patients' scores on items of the FIM to quantify their level of independence on both self-care and mobility domains. We then identified patients as requiring "no physical assistance" at discharge from inpatient rehabilitation by using a rule and score-based approach. In those patients with FIM self-care and mobility summary scores suggesting no physical assistance needed, we found that physical assistance was in fact needed frequently in bathroom-related activities (eg, continence, toilet and tub transfers, hygiene, clothes management) and with stairs. It was not uncommon for actual performance to be lower than what may be suggested by a summary score of those domains. Further research is needed to create clinically meaningful descriptions of summary scores from combined performances on individual items of physical functioning. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Troponin Limit of Detection Plus Cardiac Risk Stratification Scores to Rule Out Acute Myocardial Infarction and 30-Day Major Adverse Cardiac Events in ED Patients.

PubMed

Datlow, Mitchell D; Gray, Kelly M; Watts, Adriel; Diercks, Deborah B; Mumma, Bryn E

2017-12-01

When screening for acute myocardial infarction (AMI), troponin levels below the 99th percentile, including those below the limit of detection (LOD), are considered normal. We hypothesized that a low-risk HEART score (0-3) or ACS Pretest Probability Assessment <2% plus a single troponin below the LOD would rule out both AMI and 30-day major adverse cardiac events (MACE). We studied all patients who presented to a single academic emergency department and received a troponin I (Siemens Ultra Troponin I) from September 1, 2013, to November 13, 2013 (n=888). Demographic and clinical data were abstracted from the electronic medical record. Primary outcome was a final encounter diagnosis of myocardial infarction. Secondary outcome was 30-day MACE, defined as composite of myocardial infarction, revascularization, or death from a cardiac or uncertain etiology. Sensitivities of low-risk HEART score and ACS Pretest Probability <2% alone were 98% (95% confidence interval [CI], 89%-100%) and 96% (95% CI, 86%-100%) for AMI and 94% (95% CI, 86%-98%) and 95% (95% CI, 88%-99%), respectively, for 30-day MACE. When combined with troponin below the LOD, sensitivity for AMI was 100% (95% CI, 93%-100%; difference 2%; 95% CI, -2% to 6%) for low-risk HEART Score and 100% (95% CI, 93%-100%; difference 4%; 95% CI, -1.5% to 10%) for ACS Pretest Probability <2%. When combined with troponin below the LOD, sensitivity for 30-day MACE was 100% (95% CI, 95%-100%; difference 6%; 95% CI, 1%-12%) for low-risk HEART Score and 100% (95% CI, 95%-100%; difference 5%; 95% CI, 0.2%-10%) for ACS Pretest Probability <2%. Addition of a single troponin below the LOD to these scores improves sensitivity for 30-day MACE.

Catering to millennial learners: assessing and improving fine-needle aspiration performance.

PubMed

Rowse, Phillip G; Ruparel, Raaj K; AlJamal, Yazan N; Abdelsattar, Jad M; Heller, Stephanie F; Farley, David R

2014-01-01

Fine-needle aspiration (FNA) of a palpable cervical lymph node is a straightforward procedure that should be safely performed by educated general surgery (GS) trainees. Retention of technical skill is suspect, unless sequential learning experiences are provided. However, voluntary learning experiences are no guarantee that trainees will actually use the resource. A 3-minute objective structured assessment of technical skill-type station was created to assess GS trainee performance using FNA. Objective criteria were developed and a checklist was generated (perfect score = 24). Following abysmal performance of 11 postgraduate year (PGY)-4 trainees on the FNA station of our semiannual surgical skills assessment ("X-Games"), we provided all GS residents with electronic access to a 90-second YouTube video clip demonstrating proper FNA technique. PGY-2 (n = 11) and PGY-3 (n = 10) residents subsequently were tested on FNA technique 5 and 12 days later, respectively. All 32 trainees completed the station in less than 3 minutes. Overall scores ranged from 4 to 24 (mean = 14.9). PGY-4 residents assessed before the creation of the video clip scored lowest (range: 4-18, mean = 11.4). PGY-3 residents (range: 10-22, mean = 17.8) and PGY-2 residents (range: 10-24, mean = 15.8) subsequently scored higher (p < 0.05). Ten residents admitted watching the 90-second FNA video clip and scored higher (mean = 21.7) than the 11 residents that admitted they did not watch the clip (mean = 13.1, p < 0.001). Of the 11 trainees who did not watch the video, 6 claimed they did not have time, and 5 felt it would not be useful to them. Overall performance of FNA was poor in 32 midlevel GS residents. However, a 90-second video clip demonstrating proper FNA technique viewed less than 2 weeks before the examination significantly elevated scores. Half of trainees given the chance to learn online did not take the opportunity to view the video clip. Although preemptive learning is effective, future efforts should attempt to improve self-directed learning habits of trainees and evaluate actual long-term skill retention. Copyright © 2014. Published by Elsevier Inc.

Floquet-Network Theory of Nonreciprocal Transport

NASA Astrophysics Data System (ADS)

Li, Huanan; Kottos, Tsampikos; Shapiro, Boris

2018-04-01

We develop a theoretical framework that lays out the fundamental rules under which a periodic (Floquet) driving scheme can induce nonreciprocal transport. Our approach utilizes an extended Hilbert space where a Floquet network with an extra (frequency) dimension naturally arises. The properties of this network (its on-site potential and the intersite couplings) are in one-to-one correspondence with the initial driving scheme. Its proper design allows for a control of the multipath scattering processes and the associated interferences. We harness this degree of freedom to realize driving schemes with narrow-band or broadband nonreciprocal transport.

An Examination of "The Martian" Trajectory

NASA Technical Reports Server (NTRS)

Burke, Laura

2015-01-01

This analysis was performed to support a request to examine the trajectory of the Hermes vehicle in the novel "The Martian" by Andy Weir. Weir developed his own tool to perform the analysis necessary to provide proper trajectory information for the novel. The Hermes vehicle is the interplanetary spacecraft that shuttles the crew to and from Mars. It is notionally a Nuclear powered vehicle utilizing VASIMR engines for propulsion. The intent of this analysis was the determine whether the trajectory as it was outlined in the novel is consistent with the rules of orbital mechanics.

Ethics in biomedical engineering.

PubMed

Morsy, Ahmed; Flexman, Jennifer

2008-01-01

This session focuses on a number of aspects of the subject of Ethics in Biomedical Engineering. The session starts by providing a case study of a company that manufactures artificial heart valves where the valves were failing at an unexpected rate. The case study focuses on Biomedical Engineers working at the company and how their education and training did not prepare them to deal properly with such situation. The second part of the session highlights the need to learn about various ethics rules and policies regulating research involving human or animal subjects.

76 FR 77128 - Alternate Tonnage Threshold for Oil Spill Response Vessels

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-12

...The Coast Guard is establishing an alternate size threshold based on the measurement system established under the International Convention on Tonnage Measurement of Ships, 1969, for Oil Spill Response Vessels (OSRVs), which are properly certificated under 46 CFR subchapter L. The present size threshold of 500 gross registered tons is based on the U.S. regulatory measurement system. This rule provides an alternative for owners and operators of offshore supply vessels (OSVs) that may result in an increase in oil spill response capacity and capability.

Reply to Colom and Abad (2006)

ERIC Educational Resources Information Center

Mackintosh, N. J.

2007-01-01

Mackintosh and Bennett [Mackintosh, N. J., Bennett, E. S. (2005). What do Raven's Matrices measure? An analysis in terms of sex differences. "Intelligence, 33," 663-674] reported that male students obtained higher scores than females on Raven's items that required for their solution addition/subtraction or distribution of two rules, but…

Physical Activity & Sport for the Secondary School Student. Fifth Edition.

ERIC Educational Resources Information Center

Dougherty, Neil J., Ed.

This collection of papers offers a comprehensive text about contemporary physical activities and sports forms. It provides students with an overview of the various physical activities, skill technique required, safety, scoring, rules and etiquette, strategies, equipment, and related terminology. The 26 papers are: (1) "Physical Fitness"…

Spotting Incorrect Rules in Signed-Number Arithmetic by the Individual Consistency Index.

DTIC Science & Technology

1981-08-01

meaning of dimensionality of achievement data. It also shows the importance of construct validity, even in criterion referenced testing of the cognitive ... aspect of performance, and that the traditional means of item analysis that are based on taking the variances of binary scores and content analysis

Procedures for Empirical Determination of En-Route Criterion Levels.

ERIC Educational Resources Information Center

Moncrief, Michael H.

En-route Criterion Levels (ECLs) are defined as decision rules for predicting pupil readiness to advance through an instructional sequence. This study investigated the validity of present ELCs in an individualized mathematics program and tested procedures for empirically determining optimal ECLs. Retest scores and subsequent progress were…

Collaborative Data Mining Tool for Education

ERIC Educational Resources Information Center

Garcia, Enrique; Romero, Cristobal; Ventura, Sebastian; Gea, Miguel; de Castro, Carlos

2009-01-01

This paper describes a collaborative educational data mining tool based on association rule mining for the continuous improvement of e-learning courses allowing teachers with similar course's profile sharing and scoring the discovered information. This mining tool is oriented to be used by instructors non experts in data mining such that, its…

Drug side effect extraction from clinical narratives of psychiatry and psychology patients

PubMed Central

Kocher, Jean-Pierre A; Chute, Christopher G; Savova, Guergana K

2011-01-01

Objective To extract physician-asserted drug side effects from electronic medical record clinical narratives. Materials and methods Pattern matching rules were manually developed through examining keywords and expression patterns of side effects to discover an individual side effect and causative drug relationship. A combination of machine learning (C4.5) using side effect keyword features and pattern matching rules was used to extract sentences that contain side effect and causative drug pairs, enabling the system to discover most side effect occurrences. Our system was implemented as a module within the clinical Text Analysis and Knowledge Extraction System. Results The system was tested in the domain of psychiatry and psychology. The rule-based system extracting side effects and causative drugs produced an F score of 0.80 (0.55 excluding allergy section). The hybrid system identifying side effect sentences had an F score of 0.75 (0.56 excluding allergy section) but covered more side effect and causative drug pairs than individual side effect extraction. Discussion The rule-based system was able to identify most side effects expressed by clear indication words. More sophisticated semantic processing is required to handle complex side effect descriptions in the narrative. We demonstrated that our system can be trained to identify sentences with complex side effect descriptions that can be submitted to a human expert for further abstraction. Conclusion Our system was able to extract most physician-asserted drug side effects. It can be used in either an automated mode for side effect extraction or semi-automated mode to identify side effect sentences that can significantly simplify abstraction by a human expert. PMID:21946242

Time 2 tlk 2nite: Youths’ use of electronic media during family meals and associations with demographic characteristics, family characteristics and foods served

PubMed Central

Loth, Katie; Bruening, Meg; Berge, Jerica; Eisenberg, Marla E.; Neumark-Sztainer, Dianne

2014-01-01

The study purpose was to examine the frequency of adolescents’ use of electronic media (TV/movie watching, text messaging, talking on the phone, listening to music with headphones and playing with handheld games) at family meals and examine associations with demographic characteristics, rules about media use, family characteristics and the types of foods served at meals using an observational, cross-sectional design. Data were drawn from two coordinated, population-based studies of adolescents (EAT 2010) and their parents (Project F-EAT (Families and Eating Among Teens)). Surveys were completed in 2009–2010. Frequent TV/movie watching during family meals by youth was reported by 25.5% of parents. Multivariate logistic regression analyses indicated significantly higher odds of mealtime media use (p<.05) for girls and older teens. Additionally, higher odds of mealtime media use (p<.05) were also seen among those whose parents had low education levels or were black or Asian; having parental rules about media use significantly reduced these odds. Frequent mealtime media use was significantly associated with lower scores on family communication (p <.05) and scores indicating less importance placed on mealtimes (p<.001). Furthermore, frequent mealtime media use was associated with lower odds of serving green salad, fruit, vegetables, 100% juice and milk at meals whereas higher odds were seen for serving sugar-sweetened beverages (p<.05). The ubiquitous use of mealtime media by adolescents, differences by gender, race/ethnicity, age and parental rules suggest that supporting parents in their efforts to initiate and follow-through on setting mealtime media use rules may be an important public health strategy. PMID:24361006

Time 2 tlk 2nite: use of electronic media by adolescents during family meals and associations with demographic characteristics, family characteristics, and foods served.

PubMed

Fulkerson, Jayne A; Loth, Katie; Bruening, Meg; Berge, Jerica; Eisenberg, Marla E; Neumark-Sztainer, Dianne

2014-07-01

We examined the frequency of adolescents' use of electronic media (ie, television/movie watching, text messaging, talking on the telephone, listening to music with headphones, and playing with hand-held games) at family meals and examined associations with demographic characteristics, rules about media use, family characteristics, and the types of foods served at meals using an observational, cross-sectional design. Data were drawn from two coordinated, population-based studies of adolescents (Project Eating Among Teens 2010) and their parents (Project Families and Eating Among Teens). Surveys were completed during 2009-2010. Frequent television/movie watching during family meals by youth was reported by 25.5% of parents. Multivariate logistic regression analyses indicated significantly higher odds of mealtime media use (P<0.05) for girls and older teens. In addition, higher odds of mealtime media use (P<0.05) were also seen among those whose parents had low education levels or were black or Asian; having parental rules about media use significantly reduced these odds. Frequent mealtime media use was significantly associated with lower scores on family communication (P<0.05) and scores indicating less importance placed on mealtimes (P<0.001). Furthermore, frequent mealtime media use was associated with lower odds of serving green salad, fruit, vegetables, 100% juice, and milk at meals, whereas higher odds were seen for serving sugar-sweetened beverages (P<0.05). The ubiquitous use of mealtime media by adolescents and differences by sex, race/ethnicity, age, and parental rules suggest that supporting parents in their efforts to initiate and follow-through on setting mealtime media use rules may be an important public health strategy. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Predicting the duration of sickness absence for patients with common mental disorders in occupational health care.

PubMed

Nieuwenhuijsen, Karen; Verbeek, Jos H A M; de Boer, Angela G E M; Blonk, Roland W B; van Dijk, Frank J H

2006-02-01

This study attempted to determine the factors that best predict the duration of absence from work among employees with common mental disorders. A cohort of 188 employees, of whom 102 were teachers, on sick leave with common mental disorders was followed for 1 year. Only information potentially available to the occupational physician during a first consultation was included in the predictive model. The predictive power of the variables was tested using Cox's regression analysis with a stepwise backward selection procedure. The hazard ratios (HR) from the final model were used to deduce a simple prediction rule. The resulting prognostic scores were then used to predict the probability of not returning to work after 3, 6, and 12 months. Calculating the area under the curve from the ROC (receiver operating characteristic) curve tested the discriminative ability of the prediction rule. The final Cox's regression model produced the following four predictors of a longer time until return to work: age older than 50 years [HR 0.5, 95% confidence interval (95% CI) 0.3-0.8], expectation of duration absence longer than 3 months (HR 0.5, 95% CI 0.3-0.8), higher educational level (HR 0.5, 95% CI 0.3-0.8), and diagnosis depression or anxiety disorder (HR 0.7, 95% CI 0.4-0.9). The resulting prognostic score yielded areas under the curves ranging from 0.68 to 0.73, which represent acceptable discrimination of the rule. A prediction rule based on four simple variables can be used by occupational physicians to identify unfavorable cases and to predict the duration of sickness absence.

Validity of the SAT® for Predicting First-Year Grades: 2011 SAT Validity Sample. Statistical Report 2013-3

ERIC Educational Resources Information Center

Patterson, Brian F.; Mattern, Krista D.

2013-01-01

The continued accumulation of validity evidence for the intended uses of educational assessments is critical to ensure that proper inferences will be made for those purposes. To that end, the College Board has continued to collect college outcome data to evaluate the relationship between SAT® scores and college success. This report provides…

Common Clinical Practice versus new PRIM Score in Predicting Coronary Heart Disease Risk

PubMed Central

Frikke-Schmidt, Ruth; Tybjærg-Hansen, Anne; Schnohr, Peter; Jensen, Gorm B.; Nordestgaard, Børge G.

2011-01-01

Objectives To compare the new Patient Rule Induction Method(PRIM) Score and common clinical practice with the Framingham Point Score for classification of individuals with respect to coronary heart disease(CHD) risk. Methods and Results PRIM Score and the Framingham Point Score were estimated for 11,444 participants from the Copenhagen City Heart Study. Gender specific cumulative incidences and 10 year absolute CHD risks were estimated for subsets defined by age, total cholesterol, high-density lipoprotein(HDL) cholesterol, blood pressure, diabetes and smoking categories. PRIM defined seven mutually exclusive subsets in women and men, with cumulative incidences of CHD from 0.01 to 0.22 in women, and from 0.03 to 0.26 in men. PRIM versus Framingham Point Score found 11% versus 4% of all women, and 31% versus 35% of all men to have 10 year CHD risks >20%. Among women ≥65 years with hypertension and/or with diabetes, 10 year CHD risk >20% was found for 100% with PRIM scoring but for only 18% with the Framingham Point Score. Conclusion Compared to the PRIM Score, common clinical practice with the Framingham Point Score underestimates CHD risk in women, especially in women ≥65 years with hypertension and/or with diabetes. PMID:20728887

Prediction of distal residue participation in enzyme catalysis

PubMed Central

Brodkin, Heather R; DeLateur, Nicholas A; Somarowthu, Srinivas; Mills, Caitlyn L; Novak, Walter R; Beuning, Penny J; Ringe, Dagmar; Ondrechen, Mary Jo

2015-01-01

A scoring method for the prediction of catalytically important residues in enzyme structures is presented and used to examine the participation of distal residues in enzyme catalysis. Scores are based on the Partial Order Optimum Likelihood (POOL) machine learning method, using computed electrostatic properties, surface geometric features, and information obtained from the phylogenetic tree as input features. Predictions of distal residue participation in catalysis are compared with experimental kinetics data from the literature on variants of the featured enzymes; some additional kinetics measurements are reported for variants of Pseudomonas putida nitrile hydratase (ppNH) and for Escherichia coli alkaline phosphatase (AP). The multilayer active sites of P. putida nitrile hydratase and of human phosphoglucose isomerase are predicted by the POOL log ZP scores, as is the single-layer active site of P. putida ketosteroid isomerase. The log ZP score cutoff utilized here results in over-prediction of distal residue involvement in E. coli alkaline phosphatase. While fewer experimental data points are available for P. putida mandelate racemase and for human carbonic anhydrase II, the POOL log ZP scores properly predict the previously reported participation of distal residues. PMID:25627867

Evidence synthesis for medical decision making and the appropriate use of quality scores.

PubMed

Doi, Suhail A R

2014-09-01

Meta-analyses today continue to be run using conventional random-effects models that ignore tangible information from studies such as the quality of the studies involved, despite the expectation that results of better quality studies reflect more valid results. Previous research has suggested that quality scores derived from such quality appraisals are unlikely to be useful in meta-analysis, because they would produce biased estimates of effects that are unlikely to be offset by a variance reduction within the studied models. However, previous discussions took place in the context of such scores viewed in terms of their ability to maximize their association with both the magnitude and direction of bias. In this review, another look is taken at this concept, this time asserting that probabilistic bias quantification is not possible or even required of quality scores when used in meta-analysis for redistribution of weights. The use of such a model is contrasted with the conventional random effects model of meta-analysis to demonstrate why the latter is inadequate in the face of a properly specified quality score weighting method. © 2014 Marshfield Clinic.

Robot decisions: on the importance of virtuous judgment in clinical decision making.

PubMed

Gelhaus, Petra

2011-10-01

The aim of this article is to argue for the necessity of emotional professional virtues in the understanding of good clinical practice. This understanding is required for a proper balance of capacities in medical education and further education of physicians. For this reason an ideal physician, incarnating the required virtues, skills and knowledge is compared with a non-emotional robot that is bound to moral rules. This fictive confrontation is meant to clarify why certain demands on the personality of the physician are justified, in addition to a rule- and principle-based moral orientation and biomedical knowledge and skills. Philosophical analysis of thought experiments inspired by science fiction literature by Isaac Asimov. Although prima facie a rule-oriented robot seems more reliable and trustworthy, the complexity of clinical judgment is not met by an encompassing and never contradictory set of rules from which one could logically derive decisions. There are different ways how the robot could still work, but at the cost of the predictability of its behaviour and its moral orientation. In comparison, a virtuous human doctor who is also bound to these rules, although less strictly, will more reliably keep at moral objectives, be understandable, be more flexible in case the rules come to their limits, and will be more predictable in these critical situations. Apart from these advantages of the virtuous human doctor referring to her own person, the most problematic deficit of the robot is its lacking deeper understanding of the inner mental events of patients which makes good contact, good communication and good influence impossible. Although an infallibly rule-oriented robot seems more reliable at first view, in situations that require complex decisions like clinical practice the agency of a moral human person is more trustworthy. Furthermore, the understanding of the patient's emotions must remain insufficient for a non-emotional, non-human being. Because these are crucial preconditions for good clinical practice, enough attention should be given to develop these virtues and emotional skills, in addition to the usual attention on knowledge, technical skills and the obedience to moral rules and principles. © 2011 Blackwell Publishing Ltd.

[Scores and stages in pneumology].

PubMed

Kuhn, Max

2013-10-01

Useful scales and classifications for patients with pulmonary diseases are discussed. The modified Medical Research Council breathlessness scale (mMRC) is a measure of disability in lung patients. The GOLD classifications, the COPD-Assessment Test (CAT) and the BODE Index are important to classify the severity of COPD and to measure the disability of these patients. The Geneva score is a clinical prediction rule used in determining the pre-test probability of pulmonary embolism. The Pulmonary Embolism Severity Index (PESI) is a scoring system used to predict 30 day mortality in patients with pulmonary embolism. The Epworth Sleepiness Scale is intended to measure daytime sleepiness in patients with sleep apnea syndrome. The Asthma Controll Test (ACT) determines if asthma symptoms are well controlled.

Ayurpharmacoepidemiology Perspective

PubMed Central

Debnath, Parikshit; Natasha, Khurshid; Ali, Liaquat; Bhaduri, Tapas; Roy, Tushar Kanti; Bera, Sayantan; Mukherjee, Debdeep; Debnath, Swati

2016-01-01

Older Indian diabetics lack proper health literacy making them vulnerable to complications. Assessment of health literacy was done by hospital-based cross-sectional study. Face-to-face interview was conducted by pretested structured questionnaires. Diabetes patients aged ≥60 years consisted of 56.22% males and 43.78% females; in addition, 34.2% respondents were without formal schooling. Diabetes was known to 63.56% respondents. Total knowledge and practice score of the respondents was good (18.9% and 35.1%), average (30.7% and 46.9%), and poor (50.4% and 18%), respectively. Knowledge and practice score was strongly associated (P < .01) with religion, educational status, and diabetes duration with positive relationship (R 2 = 0.247, P < .01) between knowledge and practice score. The study highlights lack of health literacy among older diabetics undergoing ayurveda management. Baseline statistics will pave the way toward ayurpharmacoepidemiology. PMID:27074784

KATTS: a framework for maximizing NCLEX-RN performance.

PubMed

McDowell, Betsy M

2008-04-01

A key indicator of the quality of a nursing education program is the performance of its graduates as first-time takers of the NCLEX-RN. As a result, nursing schools are open to strategies that strengthen the performance of their graduates on the examination. The Knowledge base, Anxiety control, Test-Taking Skills (KATTS) framework focuses on the three components of achieving a maximum score on an examination. In KATTS, all three components must be present and in proper balance to maximize a test taker's score. By strengthening not just one but all of these components, graduates can improve their overall test scores significantly. Suggested strategies for strengthening each component of KATTS are provided. This framework has been used successfully in designing remedial tutoring programs and in assisting first-time NCLEX test takers in preparing for the licensing examination.

Validation of risk stratification for children with febrile neutropenia in a pediatric oncology unit in India.

PubMed

Das, Anirban; Trehan, Amita; Oberoi, Sapna; Bansal, Deepak

2017-06-01

The study aims to validate a score predicting risk of complications in pediatric patients with chemotherapy-related febrile neutropenia (FN) and evaluate the performance of previously published models for risk stratification. Children diagnosed with cancer and presenting with FN were evaluated in a prospective single-center study. A score predicting the risk of complications, previously derived in the unit, was validated on a prospective cohort. Performance of six predictive models published from geographically distinct settings was assessed on the same cohort. Complications were observed in 109 (26.3%) of 414 episodes of FN over 15 months. A risk score based on undernutrition (two points), time from last chemotherapy (<7 days = two points), presence of a nonupper respiratory focus of infection (two points), C-reactive protein (>60 mg/l = five points), and absolute neutrophil count (<100 per μl = two points) was used to stratify patients into "low risk" (score <7, n = 208) and assessed using the following parameters: overall performance (Nagelkerke R 2 = 34.4%), calibration (calibration slope = 0.39; P = 0.25 in Hosmer-Lemeshow test), discrimination (c-statistic = 0.81), overall sensitivity (86%), negative predictive value (93%), and clinical net benefit (0.43). Six previously published rules demonstrated inferior performance in this cohort. An indigenous decision rule using five simple predefined variables was successful in identifying children at risk for complications. Prediction models derived in developed nations may not be appropriate for low-middle-income settings and need to be validated before use. © 2016 Wiley Periodicals, Inc.

A comparison of ensemble post-processing approaches that preserve correlation structures

NASA Astrophysics Data System (ADS)

Schefzik, Roman; Van Schaeybroeck, Bert; Vannitsem, Stéphane

2016-04-01

Despite the fact that ensemble forecasts address the major sources of uncertainty, they exhibit biases and dispersion errors and therefore are known to improve by calibration or statistical post-processing. For instance the ensemble model output statistics (EMOS) method, also known as non-homogeneous regression approach (Gneiting et al., 2005) is known to strongly improve forecast skill. EMOS is based on fitting and adjusting a parametric probability density function (PDF). However, EMOS and other common post-processing approaches apply to a single weather quantity at a single location for a single look-ahead time. They are therefore unable of taking into account spatial, inter-variable and temporal dependence structures. Recently many research efforts have been invested in designing post-processing methods that resolve this drawback but also in verification methods that enable the detection of dependence structures. New verification methods are applied on two classes of post-processing methods, both generating physically coherent ensembles. A first class uses the ensemble copula coupling (ECC) that starts from EMOS but adjusts the rank structure (Schefzik et al., 2013). The second class is a member-by-member post-processing (MBM) approach that maps each raw ensemble member to a corrected one (Van Schaeybroeck and Vannitsem, 2015). We compare variants of the EMOS-ECC and MBM classes and highlight a specific theoretical connection between them. All post-processing variants are applied in the context of the ensemble system of the European Centre of Weather Forecasts (ECMWF) and compared using multivariate verification tools including the energy score, the variogram score (Scheuerer and Hamill, 2015) and the band depth rank histogram (Thorarinsdottir et al., 2015). Gneiting, Raftery, Westveld, and Goldman, 2005: Calibrated probabilistic forecasting using ensemble model output statistics and minimum CRPS estimation. Mon. Wea. Rev., {133}, 1098-1118. Scheuerer and Hamill, 2015. Variogram-based proper scoring rules for probabilistic forecasts of multivariate quantities. Mon. Wea. Rev. {143},1321-1334. Schefzik, Thorarinsdottir, Gneiting. Uncertainty quantification in complex simulation models using ensemble copula coupling. Statistical Science {28},616-640, 2013. Thorarinsdottir, M. Scheuerer, and C. Heinz, 2015. Assessing the calibration of high-dimensional ensemble forecasts using rank histograms, arXiv:1310.0236. Van Schaeybroeck and Vannitsem, 2015: Ensemble post-processing using member-by-member approaches: theoretical aspects. Q.J.R. Meteorol. Soc., 141: 807-818.

The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study

PubMed Central

Hausfater, Pierre; Amin, Devendra; Amin, Adina; Canavaggio, Pauline; Sauvin, Gabrielle; Bernard, Maguy; Conca, Antoinette; Haubitz, Sebastian; Struja, Tristan; Huber, Andreas; Mueller, Beat; Schuetz, Philipp

2016-01-01

Introduction The inflammatory biomarker pro-adrenomedullin (ProADM) provides additional prognostic information for the risk stratification of general medical emergency department (ED) patients. The aim of this analysis was to develop a triage algorithm for improved prognostication and later use in an interventional trial. Methods We used data from the multi-national, prospective, observational TRIAGE trial including consecutive medical ED patients from Switzerland, France and the United States. We investigated triage effects when adding ProADM at two established cut-offs to a five-level ED triage score with respect to adverse clinical outcome. Results Mortality in the 6586 ED patients showed a step-wise, 25-fold increase from 0.6% to 4.5% and 15.4%, respectively, at the two ProADM cut-offs (≤0.75nmol/L, >0.75–1.5nmol/L, >1.5nmol/L, p ANOVA <0.0001). Risk stratification by combining ProADM within cut-off groups and the triage score resulted in the identification of 1662 patients (25.2% of the population) at a very low risk of mortality (0.3%, n = 5) and 425 patients (6.5% of the population) at very high risk of mortality (19.3%, n = 82). Risk estimation by using ProADM and the triage score from a logistic regression model allowed for a more accurate risk estimation in the whole population with a classification of 3255 patients (49.4% of the population) in the low risk group (0.3% mortality, n = 9) and 1673 (25.4% of the population) in the high-risk group (15.1% mortality, n = 252). Conclusions Within this large international multicenter study, a combined triage score based on ProADM and established triage scores allowed a more accurate mortality risk discrimination. The TRIAGE-ProADM score improved identification of both patients at the highest risk of mortality who may benefit from early therapeutic interventions (rule in), and low risk patients where deferred treatment without negatively affecting outcome may be possible (rule out). PMID:28005916

Risk stratification by the Appendicitis Inflammatory Response score to guide decision-making in patients with suspected appendicitis.

PubMed

Scott, A J; Mason, S E; Arunakirinathan, M; Reissis, Y; Kinross, J M; Smith, J J

2015-04-01

Current management of suspected appendicitis is hampered by the overadmission of patients with non-specific abdominal pain and a significant negative exploration rate. The potential benefits of risk stratification by the Appendicitis Inflammatory Response (AIR) score to guide clinical decision-making were assessed. During this 50-week prospective observational study at one institution, the AIR score was calculated for all patients admitted with suspected appendicitis. Appendicitis was diagnosed by histological examination, and patients were classified as having non-appendicitis pain if histological findings were negative or surgery was not performed. The diagnostic performance of the AIR score and the potential for risk stratification to reduce admissions, optimize imaging and prevent unnecessary explorations were quantified. A total of 464 patients were included, of whom 210 (63·3 per cent) with non-appendicitis pain were correctly classified as low risk. However, 13 low-risk patients had appendicitis. Low-risk patients accounted for 48·1 per cent of admissions (223 of 464), 57 per cent of negative explorations (48 of 84) and 50·7 per cent of imaging requests (149 of 294). An AIR score of 5 or more (intermediate and high risk) had high sensitivity for all severities of appendicitis (90 per cent) and also for advanced appendicitis (98 per cent). An AIR score of 9 or more (high risk) was very specific (97 per cent) for appendicitis, and the majority of patients with appendicitis in the high-risk group (21 of 30, 70 per cent) had perforation or gangrene. Ultrasound imaging could not exclude appendicitis in low-risk patients (negative likelihood ratio (LR) 1·0) but could rule-in the diagnosis in intermediate-risk patients (positive LR 10·2). CT could exclude appendicitis in low-risk patients (negative LR 0·0) and rule-in appendicitis in the intermediate group (positive LR 10·9). Risk stratification of patients with suspected appendicitis by the AIR score could guide decision-making to reduce admissions, optimize utility of diagnostic imaging and prevent negative explorations. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

The Cape Town Clinical Decision Rule for Streptococcal Pharyngitis in Children

PubMed Central

Engel, Mark Emmanuel; Cohen, Karen; Gounden, Ronald; Kengne, Andre P.; Barth, Dylan Dominic; Whitelaw, Andrew C; Francis, Veronica; Badri, Motasim; Stewart, Annemie; Dale, James B.; Mayosi, Bongani M.; Maartens, Gary

2016-01-01

Background Existing clinical decision rules (CDR) to diagnose group A streptococcal (GAS) pharyngitis have not been validated in sub-Saharan Africa. We developed a locally applicable CDR while evaluating existing CDRs for diagnosing GAS pharyngitis in South African children. Methods We conducted a prospective cohort study and enrolled 997 children aged 3-15 years presenting to primary care clinics with a complaint of sore throat, and whose parents provided consent. Main outcome measures were signs and symptoms of pharyngitis, and a positive GAS culture from a throat swab. Bivariate and multivariate analyses were used to develop the clinical decision rule. In addition, the diagnostic effectiveness of six existing rules for predicting a positive culture in our cohort was assessed. Results 206 of 982 children (21%) had a positive GAS culture. Tonsillar swelling, tonsillar exudates, tender or enlarged anterior cervical lymph nodes, absence of cough and absence of rhinorrhea were associated with positive cultures in bivariate and multivariate analyses. Four variables (tonsillar swelling and one of tonsillar exudate, no rhinorrhea, no cough), when used in a cumulative score, showed 83.7% sensitivity and 32.2% specificity for GAS pharyngitis. Of existing rules tested, the McIsaac rule had the highest positive predictive value (28%), but missed 49% of the culture-positive children who should have been treated. Conclusion The new four-variable clinical decision rule for GAS pharyngitis (i.e., tonsillar swelling and one of tonsillar exudate, no rhinorrhea, no cough) outperformed existing rules for GAS pharyngitis diagnosis in children with symptomatic sore throat in Cape Town. PMID:27870815

Adolescent externalizing behaviour, psychological control, and peer rejection: Transactional links and dopaminergic moderation.

PubMed

Janssens, Annelies; Van Den Noortgate, Wim; Goossens, Luc; Verschueren, Karine; Colpin, Hilde; Claes, Stephan; Van Heel, Martijn; Van Leeuwen, Karla

2017-09-01

This study investigated (1) reciprocal links among parental psychological control, peer rejection, and adolescent externalizing (aggressive and rule-breaking behaviour), and (2) the moderating effect of an adolescent genetic factor (biologically informed polygenic score for dopamine signalling). Three-year longitudinal data from 1,116 adolescents (51% boys; M age = 13.79) and their parents included psychological measures (adolescent-reported psychological control, peer-reported rejection, and parent-reported aggressive and rule-breaking behaviour). Cross-lagged analyses showed bidirectional effects between psychological control and both aggressive and rule-breaking behaviour and a unidirectional effect of peer rejection on both forms of problem behaviour over time. Multigroup structural equation modelling revealed genetic moderation only for rule-breaking behaviour: for adolescents with intermediate levels of dopamine signalling significant environmental effects were present, whereas adolescent effects of rule-breaking behaviour on psychological control were significant for adolescents with both intermediate and high profiles and effects on peer rejection only for adolescents with high dopamine profiles. Statement of contribution What is already known on this subject? Parental psychological control is related to adolescent externalizing problems. Experiencing peer rejection reinforces aggressive and rule-breaking behaviour. Single-gene studies show that dopaminergic genes influence externalizing problems directly or in interaction with the environment. What does this study add? Parental psychological control and adolescent aggressive and rule-breaking behaviour exacerbate one another longitudinally. Longitudinal associations between peer rejection and both subtypes of externalizing behaviour are unidirectional. With a polygenic approach, dopaminergic moderation is present for rule-breaking behaviour only. © 2017 The British Psychological Society.

A Machine Learning Approach to Discover Rules for Expressive Performance Actions in Jazz Guitar Music.

PubMed

Giraldo, Sergio I; Ramirez, Rafael

2016-01-01

Expert musicians introduce expression in their performances by manipulating sound properties such as timing, energy, pitch, and timbre. Here, we present a data driven computational approach to induce expressive performance rule models for note duration, onset, energy, and ornamentation transformations in jazz guitar music. We extract high-level features from a set of 16 commercial audio recordings (and corresponding music scores) of jazz guitarist Grant Green in order to characterize the expression in the pieces. We apply machine learning techniques to the resulting features to learn expressive performance rule models. We (1) quantitatively evaluate the accuracy of the induced models, (2) analyse the relative importance of the considered musical features, (3) discuss some of the learnt expressive performance rules in the context of previous work, and (4) assess their generailty. The accuracies of the induced predictive models is significantly above base-line levels indicating that the audio performances and the musical features extracted contain sufficient information to automatically learn informative expressive performance patterns. Feature analysis shows that the most important musical features for predicting expressive transformations are note duration, pitch, metrical strength, phrase position, Narmour structure, and tempo and key of the piece. Similarities and differences between the induced expressive rules and the rules reported in the literature were found. Differences may be due to the fact that most previously studied performance data has consisted of classical music recordings. Finally, the rules' performer specificity/generality is assessed by applying the induced rules to performances of the same pieces performed by two other professional jazz guitar players. Results show a consistency in the ornamentation patterns between Grant Green and the other two musicians, which may be interpreted as a good indicator for generality of the ornamentation rules.

A Machine Learning Approach to Discover Rules for Expressive Performance Actions in Jazz Guitar Music

PubMed Central

Giraldo, Sergio I.; Ramirez, Rafael

2016-01-01

Expert musicians introduce expression in their performances by manipulating sound properties such as timing, energy, pitch, and timbre. Here, we present a data driven computational approach to induce expressive performance rule models for note duration, onset, energy, and ornamentation transformations in jazz guitar music. We extract high-level features from a set of 16 commercial audio recordings (and corresponding music scores) of jazz guitarist Grant Green in order to characterize the expression in the pieces. We apply machine learning techniques to the resulting features to learn expressive performance rule models. We (1) quantitatively evaluate the accuracy of the induced models, (2) analyse the relative importance of the considered musical features, (3) discuss some of the learnt expressive performance rules in the context of previous work, and (4) assess their generailty. The accuracies of the induced predictive models is significantly above base-line levels indicating that the audio performances and the musical features extracted contain sufficient information to automatically learn informative expressive performance patterns. Feature analysis shows that the most important musical features for predicting expressive transformations are note duration, pitch, metrical strength, phrase position, Narmour structure, and tempo and key of the piece. Similarities and differences between the induced expressive rules and the rules reported in the literature were found. Differences may be due to the fact that most previously studied performance data has consisted of classical music recordings. Finally, the rules' performer specificity/generality is assessed by applying the induced rules to performances of the same pieces performed by two other professional jazz guitar players. Results show a consistency in the ornamentation patterns between Grant Green and the other two musicians, which may be interpreted as a good indicator for generality of the ornamentation rules. PMID:28066290

Regulatory considerations in the design of comparative observational studies using propensity scores.

PubMed

Yue, Lilly Q

2012-01-01

In the evaluation of medical products, including drugs, biological products, and medical devices, comparative observational studies could play an important role when properly conducted randomized, well-controlled clinical trials are infeasible due to ethical or practical reasons. However, various biases could be introduced at every stage and into every aspect of the observational study, and consequently the interpretation of the resulting statistical inference would be of concern. While there do exist statistical techniques for addressing some of the challenging issues, often based on propensity score methodology, these statistical tools probably have not been as widely employed in prospectively designing observational studies as they should be. There are also times when they are implemented in an unscientific manner, such as performing propensity score model selection for a dataset involving outcome data in the same dataset, so that the integrity of observational study design and the interpretability of outcome analysis results could be compromised. In this paper, regulatory considerations on prospective study design using propensity scores are shared and illustrated with hypothetical examples.

Application of a modified selection index for honey bees (Hymenoptera: Apidae).

PubMed

van Engelsdorp, D; Otis, G W

2000-12-01

Nine different genetic families of honey bees (Apis mellifera L.) were compared using summed z-scores (phenotypic values) and a modified selection index (Imod). Imod values incorporated both the phenotypic scores of the different traits and the economic weightings of these traits, as determined by a survey of commercial Ontario beekeepers. Largely because of the high weight all beekeepers place on honey production, a distinct difference between line rankings based on phenotypic scores and Imod scores was apparent, thereby emphasizing the need to properly weight the traits being evaluated to select bee stocks most valuable for beekeepers. Furthermore, when beekeepers who made >10% of their income from queen and nucleus colony sales assigned relative values to the traits used in the Imod calculations, the results differed from those based on weightings assigned by honey producers. Our results underscore the difficulties the North American beekeeping industry must overcome to devise effective methods of evaluating colonies for breeding purposes.

Rational and experiential decision-making preferences of third-year student pharmacists.

PubMed

McLaughlin, Jacqueline E; Cox, Wendy C; Williams, Charlene R; Shepherd, Greene

2014-08-15

To examine the rational (systematic and rule-based) and experiential (fast and intuitive) decision-making preferences of student pharmacists, and to compare these preferences to the preferences of other health professionals and student populations. The Rational-Experiential Inventory (REI-40), a validated psychometric tool, was administered electronically to 114 third-year (P3) student pharmacists. Student demographics and preadmission data were collected. The REI-40 results were compared with student demographics and admissions data to identify possible correlations between these factors. Mean REI-40 rational scores were higher than experiential scores. Rational scores for younger students were significantly higher than students aged 30 years and older (p<0.05). No significant differences were found based on gender, race, or the presence of a prior degree. All correlations between REI-40 scores and incoming grade point average (GPA) and Pharmacy College Admission Test (PCAT) scores were weak. Student pharmacists favored rational decision making over experiential decision making, which was similar to results of studies done of other health professions.